Lauren Brooke Yancey, OD
Individual provider Active NPI Optometrist · Jasper, GA
NPI 1013608181 · NPPES record last updated Jul 12, 2023
Key facts
- NPI
- 1013608181
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- OPT003505 (GA)
- Practice address
- 150 Interstate South Dr Ste 200
Jasper, GA 30143-6250 - Phone
- (678) 454-7329
- Fax
- (678) 454-7331
- NPI assigned
- May 18, 2023
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Pennsylvania College of Optometry, 2023
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Matthew W Camp Ophthalmology LLC
Practice addresses (Care Compare)
150 Interstate S Dr
Jasper, GA 30143-6211
Phone (678) 454-7329
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230906004303 | GA | Practitioner - Optometry | 7012371255 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPT003505 | GA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Matthew W Camp Ophthalmology LLC | Multi-Specialty | Current |
Accepting new patients |
| Jonathan Woolfson, MD, P.C. | Past |
Accepting new patients |
Locations
150 Interstate South Dr
Jasper, GA 30143
Phone (678) 454-7329
150 Interstate South Dr
Ste 200
Jasper, GA 30143
Phone (678) 454-7329
Interoperability endpoints
- lyancey@gamo.intellechartdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | OPT003505 | GA | Yes |
Addresses
Primary practice location
150 Interstate South Dr Ste 200
Jasper, GA 30143-6250
Mailing address
150 Interstate South Dr Ste 200
Jasper, GA 30143-6250
Phone (678) 454-7329
Other providers in Jasper, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 12, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.