Individual provider Active NPI

John Henry Nolen Jr., M.D.

  • Ophthalmology Physician
  • Atlanta, GA
National Provider Identifier
1982974671
Registry record updated Jan 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
16404 Issued in GA
Practice address
4350 Sedberry Hill CT SE
Atlanta, GA 30339-5355
Phone
(404) 352-4293
Fax
(404) 352-4293
NPI assigned
Jan 11, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 16404 GA Primary

Addresses

Primary practice location

4350 Sedberry Hill CT SE
Atlanta, GA 30339-5355

Mailing address

4350 Sedberry Hill CT SE
Atlanta, GA 30339-5355
Phone (404) 352-4293

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160218001433 GA Order and Referring Only - OphthalmologyPractitioner - Ophthalmology 5395760763

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
16404GAMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1326240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326240000000",
    "number": "1982974671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4350 SEDBERRY HILL CT SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303395355",
            "telephone_number": "404-352-4293",
            "fax_number": "404-352-4293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 SEDBERRY HILL CT SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303395355",
            "telephone_number": "404-352-4293",
            "fax_number": "404-352-4293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLEN",
        "first_name": "JOHN",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-11",
        "last_updated": "2012-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "GA",
            "license": "16404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.