Isaiah Scott Edmonds, LDO

Primary specialty

OpticianTaxonomy code 156FX1800X

License

LDO002780 Issued in GA

Practice address

3109 E 1St St
Vidalia, GA 30474-8830

Phone

(912) 537-2436

Fax

(912) 537-2659

NPI assigned

Sep 18, 2023

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1694995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1013795343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3109 E 1ST ST",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304748830",
            "telephone_number": "912-537-2436",
            "fax_number": "912-537-2659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3109 E 1ST ST",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304748830",
            "telephone_number": "912-537-2436",
            "fax_number": "912-537-2659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMONDS",
        "first_name": "ISAIAH",
        "middle_name": "SCOTT",
        "credential": "LDO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-18",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "GA",
            "license": "LDO002780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joy M Dunn, MD
• Mary Dyal
• E & I Helping Hands Personal Care Home Inc
• East Georgia Healthcare Center, Inc.
• David S. Edmonds, O.D.
• Darel C Edwards, OD
• Kayla Edwards, CCC-SLP
• Milca Altineus Ejimone, MD
• Joshua Kyle Ellis, LPC
• Mindy Shook Ellis, ATC

• Optician in Vidalia, GA
• Providers in Vidalia, GA by specialty
• Optician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.