Signature Eyecare, Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT002026 Issued in GA

Legal business name

SIGNATURE EYECARE, INC

Practice address

10600 Davis Dr
Alpharetta, GA 30009-4746

Phone

(770) 992-6811

Fax

(770) 993-5205

NPI assigned

Oct 7, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Camilla Donald, O.D.

Title

Ceo

Phone

(404) 519-7567

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1317945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317945600000",
    "number": "1073897039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 COBB PKWY S",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300609320",
            "telephone_number": "404-519-7567",
            "fax_number": "678-418-1048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10600 DAVIS DR",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300094746",
            "telephone_number": "770-992-6811",
            "fax_number": "770-993-5205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIGNATURE EYECARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-07",
        "last_updated": "2011-10-07",
        "status": "A",
        "authorized_official_last_name": "DONALD",
        "authorized_official_first_name": "CAMILLA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "404-519-7567",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003109625A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2011; 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.