Woodstock Eyesite Inc

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

WOODSTOCK EYESITE INC

Practice address

2360 Towne Lake Pkwy Ste 104
Woodstock, GA 30189-5576

Phone

(770) 479-0123

Fax

(770) 720-0104

NPI assigned

Jan 13, 2020

Organization subpart

Yes

Parent organization

PEARLE VISIONAs reported in NPPES

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

Authorized official

Name

Ms. Jessica E Nadeau

Title

Insurance Specialist

Phone

(770) 479-0123

Specialties & licenses 1

Addresses

Other names 1

• Pearle Vision Doing business as

Part of

Woodstock Eyesite Inc

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Pearle Vision Inc

  • Eyewear Supplier
  • Rome, GA
  • NPI 1104997154
  NPPES parent name

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

{
    "created_epoch": "1578873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578873600000",
    "number": "1346880903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1455 RIVERSTONE PKWY STE 110",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301145627",
            "telephone_number": "770-479-0123",
            "fax_number": "770-720-0104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2360 TOWNE LAKE PKWY STE 104",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301895576",
            "telephone_number": "770-479-0123",
            "fax_number": "770-720-0104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODSTOCK EYESITE INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PEARLE VISION",
        "enumeration_date": "2020-01-13",
        "last_updated": "2020-01-13",
        "certification_date": "2020-01-13",
        "status": "A",
        "authorized_official_last_name": "NADEAU",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "INSURANCE SPECIALIST",
        "authorized_official_telephone_number": "770-479-0123",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pearle Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Woodstock, GA
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 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.