Individual provider Active NPI

Ranan Boyett Stimpson, OD

  • Optometrist
  • Marietta, GA
National Provider Identifier
1205961687
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1294T Issued in GA
Practice address
3700 Largent Way NW
Ste 200
Marietta, GA 30064-1670
Phone
(770) 422-2021
Fax
(770) 514-9603
NPI assigned
Feb 23, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1294T GA Primary

Addresses

Primary practice location

3700 Largent Way NW
Ste 200
Marietta, GA 30064-1670

Mailing address

3700 Largent Way NW
Ste 200
Marietta, GA 30064-1670
Phone (770) 422-2021

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20120120000387 GA Practitioner - Optometry 0941477632 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3700 Largent Way NW
Suite 200
Marietta, GA 30064-1661
Phone (770) 422-2021

3700 Largent Way NW
Suite 200
Marietta, GA 30064-1670

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1294TGAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Ranan B. Stimpson OD PC CurrentSince Jan 1, 1992 Accepting new patients

Locations

3700 Largent Way NW
Ste 200
Marietta, GA 30064
Phone (770) 422-2021

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205961687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 LARGENT WAY NW",
            "address_2": "STE 200",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300641670",
            "telephone_number": "770-422-2021",
            "fax_number": "770-514-9603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 LARGENT WAY NW",
            "address_2": "STE 200",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300641670",
            "telephone_number": "770-422-2021",
            "fax_number": "770-514-9603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STIMPSON",
        "first_name": "RANAN",
        "middle_name": "BOYETT",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "1294T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.