MARIETTA VISION CARE, INC. (NPI# 1952579435) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952579435 |
| Entity Type | Organization |
| Organization Name | MARIETTA VISION CARE, INC. |
| Practice Address |
1401 Johnson Ferry Rd Ste 148 B Marietta GA 30062-6495 |
| Practice Telephone | 7705098480 |
| Practice Fax Number | 7705090725 |
| Mailing Telephone | 7705098480 |
| Mailing Fax Number | 7705090725 |
| Enumeration Date | 2008-02-18 |
| Last Update Date | 2008-02-18 |
| Authorized Official Name | JOSE GONCALVES (OWNER) |
| Authorized Official Telephone | 7705098480 |
| Authorized Official Credential | OD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | OPT001072 | GA | Eye and Vision Services Providers |
| Street Address |
1401 JOHNSON FERRY RD STE 148 B |
| City | MARIETTA |
| State | GA |
| Zip Code | 30062-6495 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134143910 | Thomas L Haltom | Emergency Medicine | 1401 Johnson Ferry Rd, Suite 390, Marietta, GA 30062-6495 | 2006-07-26 |
| 1144771189 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 1401 Johnson Ferry Rd, Marietta, GA 30062-6495 | 2016-10-14 |
| 1861869604 | Ketan Pravinbhai Patel | Pharmacist | 1401 Johnson Ferry Rd, Marietta, GA 30062-6495 | 2015-08-27 |
| 1922352137 | Elizabeth Mccord | Pharmacist | 1401 Johnson Ferry Rd, Marietta, GA 30062-6495 | 2012-11-09 |
| 1104196740 | Boma Agboh-stroude | Pharmacist | 1401 Johnson Ferry Rd, Marietta, GA 30062-6495 | 2012-01-11 |
| 1649565789 | Mary Anne T Hawkins | Pharmacist | 1401 Johnson Ferry Rd, Marietta, GA 30062-6495 | 2011-06-16 |
| 1396913711 | Jose Goncalves, Od | Optometrist | 1401 Johnson Ferry Rd, Ste 148 B, Marietta, GA 30062-6495 | 2008-02-19 |
| 1013101195 | Georgia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1401 Johnson Ferry Rd, Marietta, GA 30062-6495 | 2007-08-30 |
| 1902937725 | Maximum Motion | Physical Therapist | 1401 Johnson Ferry Rd, Suite 380, Marietta, GA 30062-6495 | 2007-03-07 |
| 1558492280 | Rebecca A Scannaliato | Physical Therapist | 1401 Johnson Ferry Rd, Suite 380, Marietta, GA 30062-6495 | 2007-03-07 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619578051 | Pamela D Kretzmer | Social Worker | 3855 Shallowford Road, Suite 420, Marietta, GA 30062 | 2020-11-03 |
| 1932714680 | Michelle Chambless | Physical Therapist | Team Rehabilitation Ga01, LLC, 1401 Johnson Ferry Road, Suite 340, Marietta, GA 30062 | 2020-09-10 |
| 1700408887 | Life University | Chiropractor | 1323 Roswell Road, Marietta, GA 30062 | 2020-05-12 |
| 1104451160 | Sno Healthcare Group | Clinic/Center | 2424 Roswell Rd Ste 120, Marietta, GA 30062 | 2020-03-10 |
| 1811536212 | Sandy Plains Dental Group, PC | Dentist | 3460 Sandy Plains Rd, Suite 240, Marietta, GA 30062 | 2020-01-02 |
| 1073159034 | Magdala Tulcie Jodesty-jackson | Social Worker | 4343 Shalloword Road, Building H, Suite 4 Lower Level, Marietta, GA 30062 | 2019-11-25 |
| 1598235178 | Matthew Driggers | Counselor | 4343 Shallowford Rd C2, Marietta, GA 30062 | 2018-11-27 |
| 1750895785 | Emily Grace Minday | Counselor | 4343 Shallowford Road Building C, Suite 1 Lower Level, Marietta, GA 30062 | 2017-11-29 |
| 1477072122 | Jason Lee Amos | Speech-Language Pathologist | 3660 Chestnut Ridge Court, Marietta, GA 30062 | 2017-09-13 |
| 1346761376 | Marian Pomaah Opoku-agyeman | Nurse Practitioner | 4661 Andrea Pointe, Marietta, GA 30062 | 2017-06-29 |
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| 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 |
|---|---|---|---|---|
| 1376154963 | Family First Vision Care Georgia | Optometrist | 1401 Johnson Ferry Rd Ste 148b, Marietta, GA 30062-6499 | 2020-08-17 |
| 1629560032 | Jinen Shah | Optometrist | 1100 Johnson Ferry Rd Ste 120, Marietta, GA 30068-2700 | 2018-05-31 |
| 1265967509 | Samaneh Sahand | Optometrist | 2200 Roswell Rd Ste 160, Marietta, GA 30062-2984 | 2017-04-24 |
| 1457695397 | Krista Chopra | Optometrist | 621 Virginia St Apt 17, Marietta, OH 45750-2893 | 2012-11-15 |
| 1720376353 | Alfred M. Long, Jr., O.d., LLC | Optometrist | 690 Stone House Ln Nw, Marietta, GA 30064-4700 | 2011-07-18 |
| 1497073951 | Lauren Theresa Fiscale | Optometrist | 850 Old Piedmont Rd, Marietta, GA 30066-5490 | 2010-05-08 |
| 1396073862 | Wildwood Eye Care LLC | Optometrist | 1545 Powers Ferry Rd, Suite 240, Marietta, GA 30067-9412 | 2009-11-22 |
| 1326373069 | American Optical Services LLC | Optometrist | 1311 Johnson Ferry Rd, Marietta, GA 30068-2944 | 2009-10-14 |
| 1760715361 | Mital Patel | Optometrist | 3535 Roswell Rd Ste 8, Marietta, GA 30062-8827 | 2009-09-14 |
| 1639300502 | Jose Goncalves PC | Optometrist | 1401 Johnson Ferry Rd Suite 148b, Marietta, GA 30062 | 2009-07-27 |
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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.