DR. KENYATTA D. BRANTLEY (O.D.) – Optometrist, NPI 1205907565
Optometrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
959 OPTOMETRY in GA
Provider Addresses for DR. KENYATTA D. BRANTLEY (O.D.)
37 CALUMET PARKWAY BLDG G SUITE 101
ATTENTION: DR. KEN BRANTLEY
NEWNAN, GA 30263
Phone: (229) 800-4712
Type: Mailing
Boulevard South Southwest, Fleming Farms Retirement Center, Huntsville, Madison County, Alabama, 35802, United States
SUITE 104
HUNTSVILLE, AL 358022115
Phone:
Type: Mailing
15933 CLAYTON RD STE 210
BALLWIN, MO 630112172
Phone: (636) 200-4393
Type: Mailing
3339 HIGHWAY 34 E
SHARPSBURG, GA 302773564
Phone: (770) 304-2025
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 6 Open Payments records for all available years, with a total value of $1,304.
Total Amount is formed as General ($1,304) + Research ($0) + Ownership ($0) = $1,304.
Last reported payment date: 2024-10-04 • Largest payer in this snapshot: Alcon Vision LLC ($1,193).
Total Amount
$1,304
General + Research + Ownership
Payments
6
Total payment records
General Amount
$1,304
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-04
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Alcon Vision LLC | $1,193 |
| Johnson & Johnson Vision Care, Inc. | $111 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-06-04
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240604004127 | I | Optometry | GA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 30263)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O P T O M E T R Y | GA | |
| O P T O M E T R Y | GA | |
| - | GA | |
| O P T O M E T R Y | GA | |
| O P T O M E T R Y | GA | |
| O P T O M E T R Y | GA | |
| O P T O M E T R Y | GA | |
| O P T O M E T R Y | GA | |
| O P T O M E T R Y | GA | |
| - | GA |
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