SENIORWELL OF GEORGIA, LLC (NPI# 1629600424) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629600424 |
| Entity Type | Organization |
| Organization Name | SENIORWELL OF GEORGIA, LLC |
| Practice Address |
2002 Summit Blvd Ste 300 Brookhaven GA 30319-6422 |
| Mailing Address |
2100 E Lake Cook Rd Ste 1000 Buffalo Grove IL 60089-1999 |
| Practice Telephone | 8448823127 |
| Practice Fax Number | 8442465877 |
| Mailing Telephone | 8448823127 |
| Mailing Fax Number | 8442465875 |
| Enumeration Date | 2020-02-10 |
| Last Update Date | 2020-02-10 |
| Authorized Official Name | JOHN MORONEY (CEO) |
| Authorized Official Telephone | 8448823127 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | Dental Providers | ||
| N | 213E00000X | Podiatrist | Podiatric Medicine & Surgery Service Providers | ||
| N | 231H00000X | Audiologist | Speech, Language and Hearing Service Providers | ||
| Y | 152W00000X | Optometrist | Eye and Vision Services Providers |
| Other Name | Type Code |
|---|---|
| SeniorWell of Georgia, LLC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689206559 | Seniorwell of Georgia, LLC | Audiologist | 2002 Summit Blvd Ste 300, Brookhaven, GA 30319-6422 | 2020-02-10 |
| Street Address |
2002 SUMMIT BLVD STE 300 |
| City | BROOKHAVEN |
| State | GA |
| Zip Code | 30319-6422 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760993984 | Caroline M. Brackette | Counselor | 2002 Summit Blvd Ste 300, Brookhaven, GA 30319 | 2017-10-15 |
| 1689206559 | Seniorwell of Georgia, LLC | Audiologist | 2002 Summit Blvd Ste 300, Brookhaven, GA 30319-6422 | 2020-02-10 |
| 1952818288 | Epic Solutions Inc | General Practice | 2002 Summit Blvd Ste 300, Brookhaven, GA 30319-6403 | 2018-01-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215556717 | Ronika Cotton | Marriage & Family Therapist | 2002 Summit Boulevard, Suite 300, Atlanta, GA 30319 | 2020-04-14 |
| 1093369548 | Gordon Peace | Physical Therapist | 705 Town Blvd Ne S 550, Atlanta, GA 30319 | 2019-08-01 |
| 1124682281 | Tiffany Nicole Blamble | Physician Assistant | 2235 Briarwood Way Ne, Brookhaven, GA 30319 | 2019-04-24 |
| 1891286860 | Sandy Springs Center for Urologic Surgery LLC | Clinic/Center | 1450 S Johnson Ferry Rd Ste 100, Atlanta, GA 30319 | 2018-05-24 |
| 1578070355 | Aaron Knott | Physical Therapist | 4260 Peachtree Road, Atlanta, GA 30319 | 2018-01-03 |
| 1639683832 | Lauren Hamann | Physical Therapist | 3777 Peachtree Rd Ne Apt 933, Brookhaven, GA 30319 | 2017-11-27 |
| 1700328713 | Christina Head | Counselor | 1350 Dresden Drive, Atlanta, GA 30319 | 2016-11-08 |
| 1528432572 | Hillary Allyn Olivier | Occupational Therapist | 3747 Peachtree Rd, Atlanta, GA 30319 | 2015-11-13 |
| 1285025304 | Karl Weismantel | Physical Therapy Assistant | 1000 Lenox Park Blvd, Atlanta, GA 30319 | 2015-02-11 |
| 1285938704 | Marc Todd Rutherford | Pharmacist | 104 Town Blvd, Atlanta, GA 30319 | 2010-12-23 |
| Find all providers in zip 30319 | ||||
| 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 |
|---|---|---|---|---|
| 1215441357 | Envision Optics LLC | Optometrist | 3360 Buford Hwy Ne, Brookhaven, GA 30329-1710 | 2017-11-28 |
| 1962955153 | Brookleigh Family Eyecare, Inc | Optometrist | 3575 Durden Dr Ne, Suite 303, Brookhaven, GA 30319-2253 | 2016-07-25 |
| 1871971861 | Eyedeal Vision Group LLC | Optometrist | 1922 Johnson Ferry Rd Ne, Unit E, Brookhaven, GA 30319-5003 | 2015-05-11 |
| 1801122114 | Oladipo O Itabiyi | Optometrist | 1234 Harshaw Rd, Brookhaven, PA 19015-1908 | 2009-10-20 |
| 1699921023 | Tressie Hall | Optometrist | 301 Highway 51 S, Suite B, Brookhaven, MS 39601-3247 | 2008-08-18 |
| 1174714133 | Chad P Smith | Optometrist | 211 N Whitworth Ave, Brookhaven, MS 39601-3051 | 2007-08-06 |
| 1033243902 | Alan Hymowitz | Optometrist | 1418 Dresden Dr Ne Ste 150, Brookhaven, GA 30319-7002 | 2007-03-15 |
| 1720141757 | Gayle Kornman | Optometrist | 1418 Dresden Dr Ne, Brookhaven, GA 30319-3598 | 2006-12-19 |
| 1952497679 | Mark P Smith | Optometrist | 211 North Whitworth Ave, Brookhaven, MS 39601 | 2006-10-04 |
| 1861507873 | Hanh M. Nguyen O.d., P.C. | Optometrist | 1200 Lake Hearn Dr Ne Ste 150, Brookhaven, GA 30319-1445 | 2006-08-20 |
| Find all providers in BROOKHAVEN | ||||
| City | BROOKHAVEN |
| Zip Code | 30319 |
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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.