NPIMap

Organization Active NPI

Opti-Pearl Vision Center, LLC

  • Optometrist
  • Macon, GA
National Provider Identifier
1780182014
Registry record updated Feb 1, 2018
On this page

Key facts

NPPES NPI Registry
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
Last updated
Feb 1, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2018

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

Authorized official

Name
Nhathy Pham, ODNPI 1417338823
Title
Owner/Manager
Phone
(407) 929-5433

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 003061 GA Primary

Addresses

Primary practice location

5080 Riverside Dr Ste 400
Macon, GA 31210-1172

Mailing address

PO Box 7647
Macon, GA 31209-7647

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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": []
}

Other providers in Macon, GA

Sources for this page

  • 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.