Crystal A Gardner, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT002401 Issued in GA

Practice address

990 Bear Creek Blvd
Ste. D
Hampton, GA 30228-1864

Phone

(770) 707-0711

Fax

(770) 707-0811

NPI assigned

Jul 23, 2007

Last updated

Feb 6, 2012By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Ohio State University - College of Optometry, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Advanced Family Eyecare of Hampton, LLC

  • Optometrist
  • Hampton, GA
  • NPI 1942580428
  Medicare reassignment NPD Authorized official
• SVS Vision Inc

  • Eyewear Supplier
  • Stockbridge, GA
  • NPI 1073648424
  Medicare reassignment NPD
• SVS Vision Inc

  dba SVS Vision 94

  • Optometrist
  • Mt Pleasant, MI
  • NPI 1558246942
  NPD

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

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328486400000",
    "number": "1336349901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 BEAR CREEK BLVD",
            "address_2": "STE. D",
            "city": "HAMPTON",
            "state": "GA",
            "postal_code": "302281864",
            "telephone_number": "770-707-0711",
            "fax_number": "770-707-0811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 BEAR CREEK BLVD",
            "address_2": "STE. D",
            "city": "HAMPTON",
            "state": "GA",
            "postal_code": "302281864",
            "telephone_number": "770-707-0711",
            "fax_number": "770-707-0811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "CRYSTAL",
        "middle_name": "A",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-23",
        "last_updated": "2012-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Freds Stores of Tennessee Inc (Freds Pharmacy 1839)
• Holly Fritzius, L.D.O.
• Full Plate Industries, LLC
• Funshine Health Care LLC
• Future Minds ABA LLC
• Simmon Gatlin, RN,
• Michelle Gay, RN
• Nicole Suzanne Gayle, PT
• Eon George, PHD, EDD, EDS, NCC
• Alethia Gilbert

• Optometrist in Hampton, GA
• Providers in Hampton, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.