Opti-Pearl Vision Center, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

003061 Issued in GA

Legal business name

OPTI-PEARL VISION CENTER, LLC

Practice address

5080 Riverside Dr Ste 400
Macon, GA 31210-1172

Phone

(478) 474-3330

Fax

(478) 474-3722

NPI assigned

Feb 1, 2018

Organization subpart

No

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

Authorized official

Name

Nhathy Pham, OD

Title

Owner/Manager

Phone

(407) 929-5433

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1517443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517443200000",
    "number": "1780182014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7647",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312097647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5080 RIVERSIDE DR STE 400",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312101172",
            "telephone_number": "478-474-3330",
            "fax_number": "478-474-3722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTI-PEARL VISION CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-01",
        "last_updated": "2018-02-01",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "NHATHY",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "407-929-5433",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "GA",
            "license": "003061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Macon, GA
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2018; 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.