Teresa Elliott, LDO

Primary specialty

OpticianTaxonomy code 156FX1800X

License

2177 Issued in GA

Practice address

5448 Whittlesey Blvd Ste B
Columbus, GA 31909-7298

Phone

(706) 322-8046

Fax

(706) 322-5621

NPI assigned

Apr 29, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Teresa Dayupay Elliott Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1714348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1265288104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5448 WHITTLESEY BLVD STE B",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319097298",
            "telephone_number": "706-322-8046",
            "fax_number": "706-322-5621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5448 WHITTLESEY BLVD STE B",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319097298",
            "telephone_number": "706-322-8046",
            "fax_number": "706-322-5621"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2801 Airport Thruway",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "GA",
            "postal_code": "319095371",
            "country_code": "US",
            "telephone_number": "706-225-5507",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3515 Victory Dr",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "GA",
            "postal_code": "319032733",
            "country_code": "US",
            "telephone_number": "706-225-1025",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6475 Gateway Rd",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "GA",
            "postal_code": "319095636",
            "country_code": "US",
            "telephone_number": "706-563-5979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "TERESA",
        "credential": "LDO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-29",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "GA",
            "license": "2177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERESA",
            "last_name": "ELLIOTT",
            "middle_name": "DAYUPAY",
            "credential": "LDO",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Elite Physicians Group, L.L.C.
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• John William Elliott-Gower, ATC, LAT
• Brian Elliott
• Desire' Marie Elliott
• Ashaunda Ellis, RBT
• Heather Nicole Ellis, MSW
• Jennifer Ellis
• Michael Alan Ellis, D.O.
• William L Ellis Sr.

• Optician in Columbus, GA
• Providers in Columbus, GA by specialty
• Optician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; 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.