Curtiss Anderson, O.D.
Individual provider Active NPI Optometrist · Atlanta, GA
NPI 1083767552 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1083767552
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 1226-T (GA)
- Practice address
- 590 Cascade Ave SW
Suite 3 and 5
Atlanta, GA 30310-2467 - Phone
- (404) 753-7777
- Fax
- (404) 753-7573
- NPI assigned
- Jan 19, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070806000321 | GA | Practitioner - Optometry | 3274624267 |
Reassigns benefits to 1 organization Practice locations: Atlanta, GA; Decatur, GA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1226-T | GA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Eyecare Studio, LLC | Optometrist | Current |
Accepting new patients |
Locations
2375 Wesley Chapel Rd
Ste 6
Decatur, GA 30035
Phone (770) 987-3937
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1226-T | GA | Yes |
Addresses
Primary practice location
590 Cascade Ave SW
Suite 3 and 5
Atlanta, GA 30310-2467
Mailing address
590 Cascade Ave SW
Suite 3 and 5
Atlanta, GA 30310-2467
Phone (404) 753-7777
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40778 | Other | GA | DAVIS VISION |
| 75115 | Other | GA | GA HEALTHY FAMILIES |
| 07565 | Other | GA | SPECTRA |
Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.