Blue Ridge Vision, Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

BLUE RIDGE VISION, INC.

Practice address

180 Toccoa CT
Ellijay, GA 30540-0604

Phone

(770) 402-1175

NPI assigned

Mar 6, 2021

Last updated

Mar 6, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Michael R Doucette Jr., LDONPI 1275305708

Title

Owner

Phone

(770) 402-1175

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael R Doucette Jr., LDO

  • Optician
  • Ellijay, GA
  • NPI 1275305708
  NPD Authorized official

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

{
    "created_epoch": "1614988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614988800000",
    "number": "1235724774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 TOCCOA CT",
            "city": "ELLIJAY",
            "state": "GA",
            "postal_code": "305400604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 TOCCOA CT",
            "city": "ELLIJAY",
            "state": "GA",
            "postal_code": "305400604",
            "telephone_number": "770-402-1175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE VISION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-06",
        "last_updated": "2021-03-06",
        "certification_date": "2021-03-06",
        "status": "A",
        "authorized_official_last_name": "DOUCETTE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-402-1175",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "LDO"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beginnings Psychology Inc
• Candace Benoit-Pinette, MD
• Bio-Medical Applications of Georgia, Inc. (FMC Dialysis Services of Ellijay)
• Lesley Ann Bishop
• Blue Ridge Mountain Internal Medicine PC
• Leigh F. Bolton, RPH
• Michel Bordeau, MA, LCSW
• Theresa Bowman
• Brittany Renel Brown
• Sheree Brown

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2021; 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.