Doublevision Eye Care Ga, LLC

Key facts

NPI

1104410133

Entity type

Organization (NPI type 2)

Primary specialty

Optometrist 152W00000X

Legal business name

DOUBLEVISION EYE CARE GA, LLC

Practice address

6516 Kitten Lake Dr Ste E8
Midland, GA 31820-3840

Phone

(205) 370-7441

NPI assigned

Feb 20, 2021

Organization subpart

No

Authorized official

Name

Lakesha Story, OD NPI 1063767036

Title

Optometrist

Phone

(205) 370-7441

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lakesha Tamia Story, O.D. Optometrist · Midland, GA · NPI 1063767036
  Medicare reassignment Authorized official GA
• Latesha Walker, O.D. Optometrist · Columbus, GA · NPI 1316387210
  NPD OPTOMETRIST

Medicare participation

Medicare fee-for-service enrollment

Enrolled in GA

Medicare enrollment records

National Provider Directory

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 20, 2021.

{
    "created_epoch": "1613779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613779200000",
    "number": "1104410133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4564 IVY PATCH DR",
            "city": "FORTSON",
            "state": "GA",
            "postal_code": "318086963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6516 KITTEN LAKE DR STE E8",
            "city": "MIDLAND",
            "state": "GA",
            "postal_code": "318203840",
            "telephone_number": "205-370-7441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUBLEVISION EYE CARE GA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-20",
        "last_updated": "2021-02-20",
        "certification_date": "2021-02-20",
        "status": "A",
        "authorized_official_last_name": "STORY",
        "authorized_official_first_name": "LAKESHA",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "205-370-7441",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, GA

• Quinstar Valiant Coleman
• Cierra Lavasia Cox
• Alexis Ariana Crawford
• Tynika Darrisaw, RBT
• Adedolapo Diko
• Taylor Brionne Dowd
• Frank Malcolm Doyle, DDS
• Jesusa Duncan
• Mather Floyd East, RPH
• Terry Arlene Edwards

All providers in Midland, GA · Optometrist in Georgia