Individual provider Active NPI

Youkelin Vasquez

  • Optician
  • Roswell, GA
National Provider Identifier
1245108489
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
LDO003106 Issued in GA
Practice address
970 Mansell Rd
Roswell, GA 30076-1506
Phone
(770) 993-3661
NPI assigned
Oct 28, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X LDO003106 GA Primary

Addresses

Primary practice location

970 Mansell Rd
Roswell, GA 30076-1506

Mailing address

332 Creekside Way
Roswell, GA 30076-4361

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

LicenseStateTypeSpecialty
LDO003106GAMDOptician

NPI Registry JSON

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

{
    "created_epoch": "1761609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761609600000",
    "number": "1245108489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 CREEKSIDE WAY",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300764361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "970 MANSELL RD",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300761506",
            "telephone_number": "770-993-3661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASQUEZ",
        "first_name": "YOUKELIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-28",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "GA",
            "license": "LDO003106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2025; 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.