Individual provider Active NPI

Loan Vo Unsworth, O.D.

  • Optometrist
  • Suwanee, GA
National Provider Identifier
1386846293
Registry record updated Mar 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2320 Issued in GA
Practice address
3130 Mathis Airport Pkwy Ste 308
Suwanee, GA 30024-9132
Phone
(770) 574-6090
Fax
(770) 574-6099
NPI assigned
Jun 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2320 GA Primary

Addresses

Primary practice location

3130 Mathis Airport Pkwy Ste 308
Suwanee, GA 30024-9132

Mailing address

1788 Scouts Walk
Dacula, GA 30019-7817
Phone (770) 380-3501

Other practice location 1

3333 Buford Dr Ste 2002
Buford, GA 30519-4935
Phone (678) 482-4585

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20130520000448 GA Practitioner - Optometry 5799922365 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Windermere Optique LLCGroup PAC ID 3476972886, 2 clinicians

Practice addresses (Care Compare)

3130 Mathis Airport Pkwy
Suite 308
Suwanee, GA 30024-9132
Phone (770) 574-6090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2320GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Bruce E. Reid and Associates, PC Optometrist Current Accepting new patients
Windermere Optique LLC Optometrist CurrentSince Sep 1, 2020 Accepting new patients

Locations

3333 Buford Dr
Ste 2002
Buford, GA 30519
Phone (678) 482-4491

400 Ernest W Barrett Pkwy NW
Ste 617
Kennesaw, GA 30144
Phone (770) 421-1734

3130 Mathis Airport Pkwy
Ste 308
Suwanee, GA 30024
Phone (770) 574-6090

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1180828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584316800000",
    "number": "1386846293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1788 SCOUTS WALK",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300197817",
            "telephone_number": "770-380-3501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 MATHIS AIRPORT PKWY STE 308",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300249132",
            "telephone_number": "770-574-6090",
            "fax_number": "770-574-6099"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3333 Buford Dr Ste 2002",
            "address_purpose": "LOCATION",
            "city": "Buford",
            "state": "GA",
            "postal_code": "305194935",
            "country_code": "US",
            "telephone_number": "678-482-4585",
            "fax_number": "678-482-4593",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UNSWORTH",
        "first_name": "LOAN",
        "middle_name": "VO",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-03",
        "last_updated": "2020-03-16",
        "certification_date": "2020-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "2320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

Verify at the official NPI Registry.