NPIMap

Organization Active NPI

Crystal Clear Optique

  • Optometrist
  • Fayetteville, GA
National Provider Identifier
1255927240
Registry record updated Dec 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
CRYSTAL CLEAR OPTIQUE
Practice address
840 Glynn St S Ste 344
Fayetteville, GA 30214-2004
Phone
(770) 716-7414
Fax
(770) 716-7498
NPI assigned
Dec 14, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2020

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

Authorized official

Name
Dr. Crystal WadeNPI 1326483405
Title
Ceo
Phone
(770) 716-7414

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X Primary
Vision Therapy OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152WV0400X
Contact Lens Technician/TechnologistGroup: 193200000X MULTI-SPECIALTY GROUP 156FC0800X
OpticianGroup: 193200000X MULTI-SPECIALTY GROUP 156FX1800X

Addresses

Primary practice location

840 Glynn St S Ste 344
Fayetteville, GA 30214-2004

Mailing address

7492 Parkland BND
Fairburn, GA 30213-5422
Phone (678) 800-2030

Other names 1

  • A Plus Optique Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Summitpoint@aplusoptique.com Direct

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1607904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607904000000",
    "number": "1255927240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7492 PARKLAND BND",
            "city": "FAIRBURN",
            "state": "GA",
            "postal_code": "302135422",
            "telephone_number": "678-800-2030",
            "fax_number": "770-716-7498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 GLYNN ST S STE 344",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302142004",
            "telephone_number": "770-716-7414",
            "fax_number": "770-716-7498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL CLEAR OPTIQUE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-14",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-14",
        "status": "A",
        "authorized_official_last_name": "WADE",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-716-7414",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Vision Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "156FC0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Contact Lens",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Summitpoint@aplusoptique.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "840 Glynn St S Ste 344",
            "city": "Fayetteville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302142004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "A Plus Optique",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fayetteville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2020; 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.