NPIMap

Organization Active NPI

Mel Optical LLC

  • Eyewear Supplier
  • Smyrna, GA
National Provider Identifier
1376109801
Registry record updated Feb 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
MEL OPTICAL LLC
Practice address
3295 S Cobb Dr SE Ste 200
Smyrna, GA 30080-4175
Phone
(404) 448-4745
Fax
(561) 828-8367
NPI assigned
May 9, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2021

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

Authorized official

Name
Jackie Bennett
Title
Credentialing Supervisor
Phone
(561) 433-6009

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

3295 S Cobb Dr SE Ste 200
Smyrna, GA 30080-4175

Mailing address

1943 Pleasant Hill Rd
Duluth, GA 30096-4625
Phone (561) 275-2020

Other names 1

  • My EyeLab Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mel Optical LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3295 S Cobb Dr SE
Ste 200
Smyrna, GA 30080

NPI Registry JSON

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

{
    "created_epoch": "1557360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613606400000",
    "number": "1376109801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1943 PLEASANT HILL RD",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300964625",
            "telephone_number": "561-275-2020",
            "fax_number": "561-828-8367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3295 S COBB DR SE STE 200",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300804175",
            "telephone_number": "404-448-4745",
            "fax_number": "561-828-8367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEL OPTICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-09",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "JACKIE",
        "authorized_official_title_or_position": "CREDENTIALING SUPERVISOR",
        "authorized_official_telephone_number": "561-433-6009"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "My EyeLab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Smyrna, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2021; 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.