Active NPI
Shedena Taylor Roberts, LDO
- Optician
- Leesburg, GA
National Provider Identifier
1013833656
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- LDO001657
- Practice address
- 208 Lynwood LN
Leesburg, GA 31763-4926 - Phone
- (229) 322-9595
- NPI assigned
- Jun 27, 2026
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Optician | 156FX1800X | LDO001657 | GA | Primary |
Addresses
Primary practice location
208 Lynwood LN
Leesburg, GA 31763-4926
Mailing address
208 Lynwood LN
Leesburg, GA 31763-4926
Phone (229) 322-9595
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1782518400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782518400000",
"number": "1013833656",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "208 LYNWOOD LN",
"city": "LEESBURG",
"state": "GA",
"postal_code": "317634926",
"telephone_number": "229-322-9595"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "208 LYNWOOD LN",
"city": "LEESBURG",
"state": "GA",
"postal_code": "317634926",
"telephone_number": "229-322-9595"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "SHEDENA",
"middle_name": "TAYLOR",
"credential": "LDO",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-06-27",
"last_updated": "2026-06-27",
"certification_date": "2026-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "GA",
"license": "LDO001657",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Leesburg, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.