Individual provider Active NPI

Sruthi Sethuram, OD

  • Optometrist
  • Stockbridge, GA
National Provider Identifier
1104740307
Registry record updated Aug 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT003770 Issued in GA
Practice address
550 Eagles Landing Pkwy
Stockbridge, GA 30281-9081
Phone
(678) 661-6798
NPI assigned
Aug 10, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT003770 GA Primary

Addresses

Primary practice location

550 Eagles Landing Pkwy
Stockbridge, GA 30281-9081

Mailing address

550 Eagles Landing Pkwy
Stockbridge, GA 30281-9081
Phone (678) 661-6798

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1786320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786320000000",
    "number": "1104740307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 EAGLES LANDING PKWY",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302819081",
            "telephone_number": "678-661-6798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 EAGLES LANDING PKWY",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302819081",
            "telephone_number": "678-661-6798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SETHURAM",
        "first_name": "SRUTHI",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-08-10",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockbridge, GA

Sources for this page

Verify at the official NPI Registry.