Active NPI
Hoyt Glaze, LDO
- Optician
- Marietta, GA
National Provider Identifier
1184744997
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- LDO000497
- Practice address
- 653 Cherokee St
Marietta, GA 30060 - Phone
- (770) 419-1393
- Fax
- (770) 419-8188
- NPI assigned
- Mar 29, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | LDO000497 | GA | Primary |
Addresses
Primary practice location
653 Cherokee St
Marietta, GA 30060
Mailing address
5245 Lockwood LN
Powder Springs, GA 30127-4915
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1156400001 | Other | GA | MEDICARE NSC |
| 1348A | Other | GA | VISION CARE PLAN |
| 1156400001 | Other | GA | CIGNA GOVERNMENT SERVICES |
| 7704191393 | Other | GA | VISION SERVICE PLAN |
| GA0497 | Other | GA | EYEMED |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LDO000497 | GA | MD | Optician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Georgia Eye Specialists | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Specialist
- Marietta, GA
- NPI 1790819407
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205798400000",
"number": "1184744997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5245 LOCKWOOD LN",
"city": "POWDER SPRINGS",
"state": "GA",
"postal_code": "301274915"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "653 CHEROKEE ST",
"city": "MARIETTA",
"state": "GA",
"postal_code": "30060",
"telephone_number": "770-419-1393",
"fax_number": "770-419-8188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLAZE",
"first_name": "HOYT",
"credential": "LDO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-29",
"last_updated": "2008-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "GA",
"license": "LDO000497",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE NSC",
"identifier": "1156400001",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VISION CARE PLAN",
"identifier": "1348A",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA GOVERNMENT SERVICES",
"identifier": "1156400001",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VISION SERVICE PLAN",
"identifier": "7704191393",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EYEMED",
"identifier": "GA0497",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.