Active NPI
Steven W Burton, LDO
- Optician
- Austell, GA
National Provider Identifier
1255966206
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- LDO2621
- Practice address
- 2498 Wingfield Dr
Austell, GA 30106-1762 - Phone
- (678) 357-0887
- NPI assigned
- Mar 10, 2020
- Last updated
- Mar 10, 2020
- Sex
- Male
- Sole proprietor
- Yes
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 | LDO2621 | GA | Primary |
Addresses
Primary practice location
2498 Wingfield Dr
Austell, GA 30106-1762
Mailing address
2498 Wingfield Dr
Austell, GA 30106-1762
Phone (678) 357-0887
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2621 | GA | MD | Optometrist |
| LDO2621 | GA | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583798400000",
"number": "1255966206",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2498 WINGFIELD DR",
"city": "AUSTELL",
"state": "GA",
"postal_code": "301061762",
"telephone_number": "678-357-0887"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2498 WINGFIELD DR",
"city": "AUSTELL",
"state": "GA",
"postal_code": "301061762",
"telephone_number": "678-357-0887"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURTON",
"first_name": "STEVEN",
"middle_name": "W",
"credential": "LDO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-03-10",
"last_updated": "2020-03-10",
"certification_date": "2020-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "GA",
"license": "LDO2621",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austell, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.