NPIMap

Organization Active NPI

Bolt Eye Group, LLC

  • Optometrist
  • Atlanta, GA
National Provider Identifier
1356077564
Registry record updated Jul 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
BOLT EYE GROUP, LLC
Practice address
460 Highbrook Dr.
Atlanta, GA 30342
Phone
(770) 776-9000
NPI assigned
Jul 29, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2022

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

Authorized official

Name
Susan Reimbold, O.D.NPI 1033236492
Title
Opttometrist
Phone
(770) 776-9000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

460 Highbrook Dr.
Atlanta, GA 30342

Mailing address

4180 Old Milton Parkway
Alpharetta, GA 30005

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1659052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659052800000",
    "number": "1356077564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4180 OLD MILTON PARKWAY",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "30005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 HIGHBROOK DR.",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30342",
            "telephone_number": "770-776-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOLT EYE GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-29",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A",
        "authorized_official_last_name": "REIMBOLD",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "OPTTOMETRIST",
        "authorized_official_telephone_number": "770-776-9000",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; 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.