Martha R Tribbet, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046-008470 Issued in IL

Practice address

8030 Mall Pkwy
Lithonia, GA 30038-2542

Phone

(770) 482-4835

Fax

(770) 484-7487

NPI assigned

Dec 19, 2006

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

Other names 1

• Dr. Martha R Jackson Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511827200000",
    "number": "1386708139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8030 MALL PKWY",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300382542",
            "telephone_number": "770-482-4835",
            "fax_number": "770-484-7487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8030 MALL PKWY",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300382542",
            "telephone_number": "770-482-4835",
            "fax_number": "770-484-7487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIBBET",
        "first_name": "MARTHA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2017-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-008470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARTHA",
            "last_name": "JACKSON",
            "middle_name": "R",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2017; 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.