Carlos Ivan Ortiz, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT001470 Issued in GA

Practice address

3274 Inner Perimeter Rd
Valdosta, GA 31602-1073

Phone

(229) 253-9530

NPI assigned

Sep 11, 2006

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)

Enrolled

State licenses

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023112059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4547 TILLMAN BLUFF RD",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316020822",
            "telephone_number": "229-253-8872",
            "fax_number": "229-253-0182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3274 INNER PERIMETER RD",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021073",
            "telephone_number": "229-253-9530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ",
        "first_name": "CARLOS",
        "middle_name": "IVAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT001470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Optical Associates of South Ga LLP
• Optimal Joint & Neurorehab LLC
• Lynn Orenstein, M.ED. CCC-SLP
• Jennifer Elizabeth Orr
• Orthopedic Surgeons of Georgia LLC
• Suheidy Ortiz
• Anna Osborne, LMFT
• Stephanie Cook Osheim
• Lynda Dee Davis Ott, FNP-C
• Allison Parris Owen, LMFT

• Optometrist in Valdosta, GA
• Providers in Valdosta, GA by specialty
• Optometrist in Georgia

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.