Phylllis Allen

Primary specialty

OpticianTaxonomy code 156FX1800X

License

LDO003061 Issued in GA

Practice address

803 New Franklin Rd
Lagrange, GA 30240-1827

Phone

(706) 302-6642

NPI assigned

Apr 30, 2025

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 30, 2025.

{
    "created_epoch": "1745971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745971200000",
    "number": "1104614973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "803 NEW FRANKLIN RD",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302401827",
            "telephone_number": "706-885-1444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 NEW FRANKLIN RD",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302401827",
            "telephone_number": "706-302-6642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "PHYLLLIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-30",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "GA",
            "license": "LDO003061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olumide Adeniyl Ajayi, M.D.
• Ezinne Akamiro, MD
• Clarence Terrell Alford Jr., M.D.
• Lisa Pharis Allardice, MD
• John Michael Allen, M.D.
• Robin Alligood, NP-C
• Joseph Morris Almand Jr., M.D.
• Abdallah Yousef Suleiman Almegdadi, MBBS
• Madelyn Almonte, PA-C
• Amedisys Georgia LLC

• All providers in Lagrange, GA
• Optician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2025; 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.