Parkside Optique, LLC

Primary specialty

OpticianTaxonomy code 156FX1800X

Legal business name

PARKSIDE OPTIQUE, LLC

Practice address

105 E Main St Ste 116
Woodstock, GA 30188-5013

Phone

(770) 485-7459

NPI assigned

Jul 25, 2017

Organization subpart

No

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

Authorized official

Name

Lisa Stonebraker, LDONPI 1619490489

Title

Owner/Dispensing Optician

Phone

(770) 485-7459

Specialties & licenses 2

Addresses

Locations

Practitioners 1

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

• Lisa Stonebraker

  • Optician
  • Woodstock, GA
  • NPI 1619490489
  NPD (past) Authorized official

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

{
    "created_epoch": "1500940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1500940800000",
    "number": "1164945796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 E MAIN ST STE 116",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301885013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 E MAIN ST STE 116",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301885013",
            "telephone_number": "770-485-7459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKSIDE OPTIQUE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-25",
        "last_updated": "2017-07-25",
        "status": "A",
        "authorized_official_last_name": "STONEBRAKER",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OWNER/DISPENSING OPTICIAN",
        "authorized_official_telephone_number": "770-485-7459",
        "authorized_official_credential": "LDO"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julius Park, D.M.D.
• Stacy Shoemake Park, PHARMD
• Anna Parker, PHARMD
• Ashley Nicole Parker, OTD R/L
• Taylor Nicole Parks, MS
• Christopher Lee Parman, M.D.
• Anand Parmar, DMD, MDS
• James Brittian Parramore, LPC
• Sandra Parris, SLP
• Lata Parvathaneni, MD

• Optician in Woodstock, GA
• Providers in Woodstock, GA by specialty
• Optician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2017; 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.