Active NPI
Brian Lisi, LDO, ABOC, NCLEC
- Optician
- Fort Oglethorpe, GA
National Provider Identifier
1306712005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- LDO003080
- Practice address
- 3040 Battlefield Pkwy
Fort Oglethorpe, GA 30742-4004 - Phone
- (706) 861-5622
- Fax
- (706) 861-5704
- NPI assigned
- Oct 11, 2025
- Sex
- Male
- Sole proprietor
- No
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 | LDO003080 | GA | Primary |
Addresses
Primary practice location
3040 Battlefield Pkwy
Fort Oglethorpe, GA 30742-4004
Mailing address
40 E Carolyn Cir
Ringgold, GA 30736-5523
Phone (614) 565-0365
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
| License | State | Type | Specialty |
|---|---|---|---|
| LDO003080 | GA | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1760140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1760140800000",
"number": "1306712005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 E CAROLYN CIR",
"city": "RINGGOLD",
"state": "GA",
"postal_code": "307365523",
"telephone_number": "614-565-0365",
"fax_number": "706-861-5704"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3040 BATTLEFIELD PKWY",
"city": "FORT OGLETHORPE",
"state": "GA",
"postal_code": "307424004",
"telephone_number": "706-861-5622",
"fax_number": "706-861-5704"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LISI",
"first_name": "BRIAN",
"name_prefix": "Mr.",
"credential": "LDO, ABOC, NCLEC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-10-11",
"last_updated": "2025-10-11",
"certification_date": "2025-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "GA",
"license": "LDO003080",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Oglethorpe, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 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.