Active NPI
Patricia Alice Smith, LDO
- Optician
- Blue Ridge, GA
National Provider Identifier
1750160933
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 1850
- Practice address
- Walmart
97 Commerce Drive
Blue Ridge, GA 30512 - Phone
- (706) 632-9516
- Fax
- (706) 632-9522
- NPI assigned
- Sep 26, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 1850 | GA | Primary |
Addresses
Primary practice location
Walmart
97 Commerce Drive
Blue Ridge, GA 30512
Mailing address
97 Commerce Dr
Blue Ridge, GA 30513-3677
Phone (706) 632-9516
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 |
|---|---|---|---|
| 1850 | GA | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695859200000",
"number": "1750160933",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "97 COMMERCE DR",
"city": "BLUE RIDGE",
"state": "GA",
"postal_code": "305133677",
"telephone_number": "706-632-9516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "WALMART",
"address_2": "97 COMMERCE DRIVE",
"city": "BLUE RIDGE",
"state": "GA",
"postal_code": "30512",
"telephone_number": "706-632-9516",
"fax_number": "706-632-9522"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "PATRICIA",
"middle_name": "ALICE",
"credential": "LDO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-26",
"last_updated": "2023-09-28",
"certification_date": "2023-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "GA",
"license": "1850",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blue Ridge, GA
- Tanya Marie Singler, MSN, APRN, NP-C
- Margaret-Grace Wright Sisson, PHARMD
- Skin Cancer Center of North Georgia PC
- Kimberly Dawn Slatton, APN
- Sleep Services of America
- Joshua David Snearly, NP
- Southern Drug Company, Inc
- Southern Home Care Services, Inc.
- Southern Home Care Services, Inc.
- Southern Home Care Services, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.