Active NPI
Sampson Listowell Abu, OD
- Optometrist
- Atlanta, GA
National Provider Identifier
1982433645
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPT003598
- Practice address
- 5505 Peachtree Dunwoody Rd Ste 300
Atlanta, GA 30342-1713 - Phone
- (404) 257-0814
- Fax
- (404) 843-8521
- NPI assigned
- Jul 31, 2024
- Last updated
- Jul 31, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPT003598 | GA | Primary |
Addresses
Primary practice location
5505 Peachtree Dunwoody Rd Ste 300
Atlanta, GA 30342-1713
Mailing address
5505 Peachtree Dunwoody Rd Ste 300
Atlanta, GA 30342-1713
Phone (914) 338-2129
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Drexel University College of Medicine, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1077 Baxter St
Suite 100
Athens, GA 30606-3767
Phone (706) 549-7757
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Interoperability endpoints
- sampson.abu.p41@direct.omnieyeatlanta.nextgenshare.com
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1722384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722384000000",
"number": "1982433645",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5505 PEACHTREE DUNWOODY RD STE 300",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303421713",
"telephone_number": "914-338-2129"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5505 PEACHTREE DUNWOODY RD STE 300",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303421713",
"telephone_number": "404-257-0814",
"fax_number": "404-843-8521"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ABU",
"first_name": "SAMPSON",
"middle_name": "LISTOWELL",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-07-31",
"last_updated": "2024-07-31",
"certification_date": "2024-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "GA",
"license": "OPT003598",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.