DR. JOHN C VENCILL (NPI# 1730283904) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730283904 |
| Entity Type | Individual |
| Full Name | DR. JOHN C VENCILL |
| Credential | O.D. |
| Practice Address |
1400 Hudson Bridge Rd Stockbridge GA 30281-5018 |
| Mailing Address |
2933 Summit Dr Jonesboro GA 30236-6252 |
| Practice Telephone | 6784858906 |
| Mailing Telephone | 6784858906 |
| Mailing Fax Number | 7704740698 |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2011-06-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | OPT000970 | GA | Eye and Vision Services Providers |
| Street Address |
1400 HUDSON BRIDGE RD |
| City | STOCKBRIDGE |
| State | GA |
| Zip Code | 30281-5018 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295336451 | Shanice Shardae Griffin | Pharmacist | 1400 Hudson Bridge Rd, Stockbridge, GA 30281-5018 | 2020-11-04 |
| 1255932521 | Robert Brady | Pharmacist | 1400 Hudson Bridge Rd, Stockbridge, GA 30281-5018 | 2020-11-03 |
| 1821404773 | Cameron Lee Brown | Pharmacist | 1400 Hudson Bridge Rd, Stockbridge, GA 30281-5018 | 2014-07-10 |
| 1700970860 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 1400 Hudson Bridge Rd, Stockbridge, GA 30281-5018 | 2006-10-03 |
| 1407947799 | Wal-mart Stores East, Lp | Technician/Technologist | 1400 Hudson Bridge Rd, Stockbridge, GA 30281 | 2006-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164039095 | Colette Alls | Social Worker | 447 Lakeshore Dr, Stockbridge, GA 30281 | 2020-09-24 |
| 1982216800 | Pediatric and Family Behavioral Health of Georgia | Counselor | 1004 Ulster Court, Stockbridge, GA 30281 | 2020-08-21 |
| 1518577659 | Qunique Taveka Toxey | Behavior Technician | 115 N Park Trail, Suite 123, Stockbridge, GA 30281 | 2020-08-04 |
| 1497377675 | Melanie Harvey | Pharmacist | 4467 North Henry Boulevard, Stockbridge, GA 30281 | 2020-05-11 |
| 1114550571 | Cecile Maria Dunkley Layne | Counselor | 255 Corporte Drive, Stockbridge, GA 30281 | 2020-02-13 |
| 1306407143 | Palliative Care of Georgia. LLC | Home Health | 275 Corporate Center Court Ste C, Stockbridge, GA 30281 | 2019-06-24 |
| 1154883791 | Aaliyah Nura Fardan-alexander | Nurse's Aide | 105 Singletree, Stockbridge, GA 30281 | 2019-04-02 |
| 1306306261 | Prosthetic Care, Inc. | Prosthetic/Orthotic Supplier | 150 County Club Drive, Suite 200, Stockbridge, GA 30281 | 2019-03-25 |
| 1356814172 | Kristina Louissaint | Nurse Practitioner | 650 Country Club Dr, Stockbridge, GA 30281 | 2019-01-03 |
| 1942789284 | Cameren Barnes | Physical Therapist | 5473 N Henry Blvd, Stockbridge, GA 30281 | 2018-08-08 |
| Find all providers in zip 30281 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629680830 | Mobile Medical Eye Care LLC | Optometrist | 110 Moseley Crossing Dr, Stockbridge, GA 30281-6501 | 2020-08-19 |
| 1679953293 | B3 Optical LLC | Optometrist | 550 Eales Landing Parkway, Suite 208, Stockbridge, GA 30281-9082 | 2015-06-09 |
| 1154410918 | Laura C Depoe | Optometrist | 550 Eagles Landing Parkway, Ste 208, Stockbridge, GA 30281 | 2006-10-12 |
| 1033128244 | Adam Shaikh Od and Associates PC | Optometrist | 5600 North Henry Blvd, Vision Center, Stockbridge, GA 30281 | 2006-08-05 |
| 1043247380 | Nickson Henry | Optometrist | 3564 Highway 138 Se, Stockbridge, GA 30281-4170 | 2006-06-26 |
| 1639791502 | Kira Elise Winston | Optometrist | 550 Eagles Landing Pkwy, Stockbridge, GA 30281-9081 | 2020-05-13 |
| 1114379492 | Sonya Patel | Optometrist | 550 Eagles Landing Pkwy, Stockbridge, GA 30281-9081 | 2016-07-11 |
| 1851731988 | Christina Iden Salehzadeh | Optometrist | 3552 Highway 138 Se, Stockbridge, GA 30281-4170 | 2013-07-03 |
| 1265748222 | Depoe Management, LLC | Optometrist | 550 Eagles Landing Pkwy, Suite 208, Stockbridge, GA 30281-9081 | 2010-08-27 |
| 1740420983 | Henry Vision Center LLC | Optometrist | 3564 Highway 138 Se, Stockbridge, GA 30281-4170 | 2009-02-28 |
| Find all providers in STOCKBRIDGE | ||||
| City | STOCKBRIDGE |
| Zip Code | 30281 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.