Individual provider Active NPI

Jerry Page

  • Optician
  • Atlanta, GA
National Provider Identifier
1174820781
Registry record updated Jun 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
Practice address
1075 Peachtree St NE Ste 3650
Atlanta, GA 30309-3934
Phone
(866) 927-4759
Fax
(866) 927-4759
NPI assigned
Feb 16, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X Primary

Addresses

Primary practice location

1075 Peachtree St NE Ste 3650
Atlanta, GA 30309-3934

Mailing address

1075 Peachtree St NE Ste 3650
Atlanta, GA 30309-3934
Phone (866) 927-4759

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

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": "1297814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339027200000",
    "number": "1174820781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1075 PEACHTREE ST NE STE 3650",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303093934",
            "telephone_number": "866-927-4759",
            "fax_number": "866-927-4759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 PEACHTREE ST NE STE 3650",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303093934",
            "telephone_number": "866-927-4759",
            "fax_number": "866-927-4759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAGE",
        "first_name": "JERRY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-16",
        "last_updated": "2012-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2012; 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.