Krystal Lee Walker, LDO002421

Primary specialty

OpticianTaxonomy code 156FX1800X

License

LDO002421 Issued in GA

Practice address

2592 N Columbia St
Milledgeville, GA 31061-8709

Phone

(478) 453-0800

Fax

(478) 452-2407

NPI assigned

May 21, 2025

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

• Krystal Pearl Lee Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1747785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1669264073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2592 N COLUMBIA ST",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310618889",
            "telephone_number": "478-453-0800",
            "fax_number": "478-452-2407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2592 N COLUMBIA ST",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310618709",
            "telephone_number": "478-453-0800",
            "fax_number": "478-452-2407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "KRYSTAL",
        "middle_name": "LEE",
        "credential": "LDO002421",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-21",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "GA",
            "license": "LDO002421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRYSTAL",
            "last_name": "LEE",
            "middle_name": "PEARL",
            "credential": "LDO002421",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Marlena Hostetter Waddell, OTR/L
• Wal-Mart Stores East LP (Walmart Pharmacy 10-1121)
• Wal-Mart Stores East, LP. (Walmart pharmacy 10-3164)
• Walgreen Co (Rite Aid #11839)
• Walgreen Co (Walgreens #10832)
• Tara Walker, APRN, PMHNP-BC
• Turkessa J. Walker, MD
• William I Waller III, M.D.
• Gregory S Waller, H.I.S.
• Lindsay Constance Waller, BCBA

• Optician in Milledgeville, GA
• Providers in Milledgeville, GA by specialty
• Optician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2025; 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.