Laura C Depoe, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT001486 Issued in GA

Practice address

550 Eagles Landing Parkway
Ste 208
Stockbridge, GA 30281

Phone

(770) 474-1237

Fax

(770) 474-5224

NPI assigned

Oct 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Laura C Blish Former name

Medicare fee-for-service enrollment

Enrolled in GA

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.

Enrollment records 1

Specialty

Optometry

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Depoe Eye Center PCGroup PAC ID 8224927702, 14 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Depoe Eye Center PC

  • Optometrist
  • Stockbridge, GA
  • NPI 1073730263
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267747200000",
    "number": "1154410918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 EAGLES LANDING PARKWAY",
            "address_2": "STE 208",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "30281",
            "telephone_number": "770-474-1237",
            "fax_number": "770-474-5224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 EAGLES LANDING PARKWAY",
            "address_2": "STE 208",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "30281",
            "telephone_number": "770-474-1237",
            "fax_number": "770-474-5224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPOE",
        "first_name": "LAURA",
        "middle_name": "C",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2010-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT001486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "BLISH",
            "middle_name": "C",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Optometrist in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.