T. T Underwood, Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

GA1622 Issued in GA

Legal business name

T. T UNDERWOOD, INC.

Practice address

805 Commerce Dr SW
Suite a
Conyers, GA 30094-6606

Phone

(770) 483-4831

Fax

(770) 483-4840

NPI assigned

Feb 27, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Kristi L Sherod

Title

Office Manager

Phone

(770) 483-4831

Specialties & licenses 1

Addresses

Other names 1

• Milam's Community Eyecare Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 2

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

• Stacy U Carson, O. D.

  • Optometrist
  • Conyers, GA
  • NPI 1871530964
  Medicare reassignment NPD
• Terrell Thompson Underwood, L.D.O.

  • Optician
  • Conyers, GA
  • NPI 1881729788
  NPD (past)

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321833600000",
    "number": "1447387774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 COMMERCE DR SW",
            "address_2": "SUITE A",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300946606",
            "telephone_number": "770-483-4831",
            "fax_number": "770-483-4840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 COMMERCE DR SW",
            "address_2": "SUITE A",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300946606",
            "telephone_number": "770-483-4831",
            "fax_number": "770-483-4840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "T. T UNDERWOOD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2011-11-21",
        "status": "A",
        "authorized_official_last_name": "SHEROD",
        "authorized_official_first_name": "KRISTI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "770-483-4831",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "GA",
            "license": "GA1622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Milam's Community Eyecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Roy Lamar Talley Jr., M.D.
• Cassandra Gordon Tancil, PHARM.D., BCPS

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.