Individual provider Active NPI

Donald Q Edwards, LDO

  • Optician
  • Griffin, GA
National Provider Identifier
1790821270
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
LDO000683 Issued in GA
Practice address
629 N Expressway Ste D
Griffin, GA 30223-2083
Phone
(770) 227-1331
Fax
(478) 746-9865
NPI assigned
Jan 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X LDO000683 GA Primary

Addresses

Primary practice location

629 N Expressway Ste D
Griffin, GA 30223-2083

Mailing address

3131 Pio Nono Ave
Macon, GA 31206-3027
Phone (478) 781-2159

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
LDO000683GAMDOptician

Practice roles

OrganizationSpecialtyStatusNew patients
Sight for Sore Eyes Past Accepting new patients

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": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790821270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 PIO NONO AVE",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312063027",
            "telephone_number": "478-781-2159",
            "fax_number": "478-746-9865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 N EXPRESSWAY STE D",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302232083",
            "telephone_number": "770-227-1331",
            "fax_number": "478-746-9865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "DONALD",
        "middle_name": "Q",
        "credential": "LDO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "GA",
            "license": "LDO000683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Griffin, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.