NPIMap

Organization Active NPI

Athens Vision Centers, LLC

Doing business as Athens Eye Doctors and Surgeons, LLC

  • Optometrist
  • Elberton, GA
National Provider Identifier
1972205136
Registry record updated Mar 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
ATHENS VISION CENTERS, LLC
Doing business as
Athens Eye Doctors and Surgeons, LLC
Practice address
17 S Thomas St
Elberton, GA 30635-2453
Phone
(706) 549-9993
Fax
(706) 549-4047
NPI assigned
Mar 21, 2023
Last updated
Mar 21, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
KELLER, CRYMES, & DEMARCO LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 21, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. John Henry Bo Dalton
Title
Administrator
Phone
(706) 433-2031

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X Primary
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X

Addresses

Primary practice location

17 S Thomas St
Elberton, GA 30635-2453

Mailing address

105 Trinity PL
Athens, GA 30607-2112
Phone (706) 549-9993

Other names 1

  • Athens Eye Doctors and Surgeons, LLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230718001717 GA Part B Supplier - Clinic/Group Practice 7911367255 Receives reassigned benefits from 4 practitioners
Practice locations: Elberton, GA; Toccoa, GA; Lavonia, GA

National Provider Directory

National Provider Directory
Tax ID family
Athens Eye Doctors and Surgeons LLC2 organizations share this tax ID, including this one
Part of
Keller Crymes Demarco LL

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1679356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679356800000",
    "number": "1972205136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 TRINITY PL",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306072112",
            "telephone_number": "706-549-9993",
            "fax_number": "706-549-4047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 S THOMAS ST",
            "city": "ELBERTON",
            "state": "GA",
            "postal_code": "306352453",
            "telephone_number": "706-549-9993",
            "fax_number": "706-549-4047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHENS VISION CENTERS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KELLER, CRYMES, & DEMARCO LLC",
        "enumeration_date": "2023-03-21",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A",
        "authorized_official_last_name": "DALTON",
        "authorized_official_first_name": "JOHN HENRY",
        "authorized_official_middle_name": "BO",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "706-433-2031",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Athens Eye Doctors and Surgeons, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elberton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.