Active NPI
James G Brooks, LDO
- Optician
- Marietta, GA
National Provider Identifier
1639302441
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 2087
- Practice address
- 3940 Regas Dr
Marietta, GA 30066-7102 - Phone
- (702) 882-9069
- Fax
- (770) 565-8411
- NPI assigned
- Aug 26, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contact Lens Technician/Technologist | 156FC0800X | 143958 | VA | |
| Optician | 156FX1800X | 2087 | GA | Primary |
| Optician | 156FX1800X | 351 | NV |
Addresses
Primary practice location
3940 Regas Dr
Marietta, GA 30066-7102
Mailing address
3940 Regas Dr
Marietta, GA 30066-7102
Phone (702) 882-9069
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 143958 | VA | MD | Contact Lens Technician/Technologist |
| 2087 | GA | MD | Optician |
| 351 | NV | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1251244800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1251244800000",
"number": "1639302441",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3940 REGAS DR",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300667102",
"telephone_number": "702-882-9069",
"fax_number": "770-565-8411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3940 REGAS DR",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300667102",
"telephone_number": "702-882-9069",
"fax_number": "770-565-8411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROOKS",
"first_name": "JAMES",
"middle_name": "G",
"name_prefix": "Mr.",
"credential": "LDO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-08-26",
"last_updated": "2009-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "156FC0800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Contact Lens",
"state": "VA",
"license": "143958",
"primary": false
},
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "GA",
"license": "2087",
"primary": true
},
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "NV",
"license": "351",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.