Active NPI
Agnes Adu, OD
- Optometrist
- Sugar Hill, GA
National Provider Identifier
1013034453
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 001522
- Practice address
- 373 Westwater RDG
Sugar Hill, GA 30518-5697 - Phone
- (770) 598-7512
- NPI assigned
- Mar 22, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 001522 | GA | Primary |
Addresses
Primary practice location
373 Westwater RDG
Sugar Hill, GA 30518-5697
Mailing address
373 Westwater RDG
Sugar Hill, GA 30518-5697
Phone (770) 598-7512
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: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001522 | GA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mark Lynn OD & Associates, PC | Optometrist | Current | Accepting new patients |
Locations
2929 Turner Hill Rd
Ste 2625
Lithonia, GA 30038
Phone (770) 482-5050
1905 Scenic Hwy N
Ste 1130
Snellville, GA 30078
Phone (678) 344-9954
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1013034453",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "373 WESTWATER RDG",
"city": "SUGAR HILL",
"state": "GA",
"postal_code": "305185697",
"telephone_number": "770-598-7512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "373 WESTWATER RDG",
"city": "SUGAR HILL",
"state": "GA",
"postal_code": "305185697",
"telephone_number": "770-598-7512"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADU",
"first_name": "AGNES",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "GA",
"license": "001522",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Sugar Hill, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.