Individual provider Active NPI

Tiffany Rosell, LDO

  • Optician
  • Sugar Hill, GA
National Provider Identifier
1740056845
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
LDO002788 Issued in GA
Practice address
245 Peachtree Industrial Blvd Ste 103
Sugar Hill, GA 30518-9126
Phone
(770) 778-4506
NPI assigned
Nov 29, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X LDO002788 GA Primary

Addresses

Primary practice location

245 Peachtree Industrial Blvd Ste 103
Sugar Hill, GA 30518-9126

Mailing address

635 Emerald Pkwy
Sugar Hill, GA 30518-5668
Phone (770) 778-4506

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

LicenseStateTypeSpecialty
LDO002788GAMDOptician

Practice roles

OrganizationSpecialtyStatusNew patients
Sweet View Optique Inc Optician CurrentSince Jul 21, 2024 Accepting new patients

Locations

245 Peachtree Industrial Blvd
Ste 103
Sugar Hill, GA 30518
Phone (770) 778-4506

Organizations & group practices 1

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": "1701216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1740056845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 EMERALD PKWY",
            "city": "SUGAR HILL",
            "state": "GA",
            "postal_code": "305185668",
            "telephone_number": "770-778-4506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 PEACHTREE INDUSTRIAL BLVD STE 103",
            "city": "SUGAR HILL",
            "state": "GA",
            "postal_code": "305189126",
            "telephone_number": "770-778-4506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSELL",
        "first_name": "TIFFANY",
        "name_prefix": "Mrs.",
        "credential": "LDO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-29",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "GA",
            "license": "LDO002788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar Hill, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; 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.