Sherene Theresa Vazhappilly

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT003546 Issued in OH

Practice address

5220 Jimmy Lee Smith Pkwy
Hiram, GA 30141-2739

Phone

(770) 439-1426

NPI assigned

May 4, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Spectacle, LLC

  • Optometrist
  • Smyrna, GA
  • NPI 1821688268
  NPD

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

{
    "created_epoch": "1620086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1801479068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7800 MONTGOMERY RD",
            "city": "BLUE ASH",
            "state": "OH",
            "postal_code": "452364388",
            "telephone_number": "513-793-5970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5220 JIMMY LEE SMITH PKWY",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301412739",
            "telephone_number": "770-439-1426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZHAPPILLY",
        "first_name": "SHERENE",
        "middle_name": "THERESA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-04",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "OPT003546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Two Hands Chiropractic LLC
• Jill Suzanne Twyman, DPT
• Edward Miguel Valentin, LCSW
• Rebecca Youngblood Vaughn, M.D.
• Vickie Vaughn
• Laura Verigan, MD
• Alethea Vessel-McGee, M.ED,CCC-SLP
• Ange Nilsa Fontaine Victor, REGISTERED NURSE
• Marie Guilda Vilmont-Rhea, APRN
• Vitality Health and Glow Clinic

• Optometrist in Hiram, GA
• Providers in Hiram, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.