NPIMap

Organization Active NPI

Bolt Eye Group - Gainesville, LLC

Doing business as Bolt Eye Group

  • Optometrist
  • Gainesville, GA
National Provider Identifier
1023722188
Registry record updated Apr 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
BOLT EYE GROUP - GAINESVILLE, LLC
Doing business as
Bolt Eye Group
Practice address
1201 Sherwood Park Dr NE
Gainesville, GA 30501-3444
Phone
(770) 536-3231
NPI assigned
Jan 12, 2023
Last updated
Apr 5, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2023

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

Authorized official

Name
Susan Marie Reimbold, ODNPI 1033236492
Title
Owner
Phone
(770) 776-9000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

1201 Sherwood Park Dr NE
Gainesville, GA 30501-3444

Mailing address

4180 Old Milton Pkwy Ste 1D
Alpharetta, GA 30005-2408
Phone (770) 776-9000

Other names 1

  • Bolt Eye Group Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address drsusan@reimboldeye.com Direct

National Provider Directory

National Provider Directory

Locations

1201 Sherwood Park Dr NE
Gainesville, GA 30501
Phone (770) 536-3231

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1673481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680652800000",
    "number": "1023722188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4180 OLD MILTON PKWY STE 1D",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300052408",
            "telephone_number": "770-776-9000",
            "fax_number": "678-293-8499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 SHERWOOD PARK DR NE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013444",
            "telephone_number": "770-536-3231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOLT EYE GROUP - GAINESVILLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-12",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A",
        "authorized_official_last_name": "REIMBOLD",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-776-9000",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drsusan@reimboldeye.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1201 Sherwood Park Dr NE",
            "city": "Gainesville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305013444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Bolt Eye Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gainesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 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.