Individual provider Active NPI

Ashley Lorraine Haywood

  • Optometrist
  • Atlanta, GA
National Provider Identifier
1477886893
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT003178 Issued in GA
Practice address
Spectacle Eyewear
375 18TH St
Atlanta, GA 30363
Phone
(404) 249-0423
Fax
(404) 872-2476
NPI assigned
Sep 16, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT003178 GA Primary

Addresses

Primary practice location

Spectacle Eyewear
375 18TH St
Atlanta, GA 30363

Mailing address

107 Frances Ave NE
Marietta, GA 30060-1327
Phone (307) 760-7982

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
I20191002001690 GA Practitioner - Optometry 9537284948

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT003178GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Spectacle, LLC Optometrist CurrentSince Jan 21, 2025 Accepting new patients
Eecarman OD PC Optometrist PastSince Aug 12, 2019 Accepting new patients

Locations

375 18th St NW
Atlanta, GA 30363
Phone (404) 260-6196

100 Perimeter Center Pl NE
Atlanta, GA 30346
Phone (678) 259-0888

1275 Caroline St NE
Atlanta, GA 30307
Phone (404) 260-0200

5220 Jimmy Lee Smith Pkwy
Hiram, GA 30141
Phone (770) 222-1421

2535 Dallas Hwy SW
Marietta, GA 30064
Phone (770) 250-7034

1135 Woodstock Rd
Roswell, GA 30075
Phone (770) 998-7122

2201 Cobb Pkwy SE
Smyrna, GA 30080
Phone (770) 250-7510

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": "1253059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1477886893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 FRANCES AVE NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601327",
            "telephone_number": "307-760-7982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SPECTACLE EYEWEAR",
            "address_2": "375 18TH ST",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30363",
            "telephone_number": "404-249-0423",
            "fax_number": "404-872-2476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYWOOD",
        "first_name": "ASHLEY",
        "middle_name": "LORRAINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-16",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.