Organization Active NPI

Gloria Lee

  • Optician
  • Ringgold, GA
National Provider Identifier
1124146071
Registry record updated Oct 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
LDO000851 Issued in GA
Legal business name
GLORIA LEE
Practice address
192 Lafayette St
Ringgold, GA 30736-2431
Phone
(706) 965-2020
Fax
(706) 965-2020
NPI assigned
Mar 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2016

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

Authorized official

Name
Mrs. Gloria Ann Lee, OPTICIANNPI 1407026404
Title
Owner/Optician
Phone
(706) 965-2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OpticianGroup: 193400000X SINGLE SPECIALTY GROUP 156FX1800X LDO000851 GA Primary

Addresses

Primary practice location

192 Lafayette St
Ringgold, GA 30736-2431

Mailing address

192 Lafayette St
Ringgold, GA 30736-2431
Phone (706) 965-2020

Other identifiers 1

IdentifierTypeStateIssuer
436313544BMedicaidGA

National Provider Directory

National Provider Directory

Locations

192 Lafayette St
Ringgold, GA 30736
Phone (706) 965-2020

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475712000000",
    "number": "1124146071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "192 LAFAYETTE ST",
            "city": "RINGGOLD",
            "state": "GA",
            "postal_code": "307362431",
            "telephone_number": "706-965-2020",
            "fax_number": "706-965-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "192 LAFAYETTE ST",
            "city": "RINGGOLD",
            "state": "GA",
            "postal_code": "307362431",
            "telephone_number": "706-965-2020",
            "fax_number": "706-965-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLORIA LEE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2016-10-06",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER/OPTICIAN",
        "authorized_official_telephone_number": "706-965-2020",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OPTICIAN"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "GA",
            "license": "LDO000851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "436313544B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ringgold, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2016; 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.