Lydia Geabou, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT003520 Issued in GA

Practice address

4511 Hixson Pike
Hixson, TN 37343-5067

Phone

(423) 870-3742

NPI assigned

Apr 27, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

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

Specialty

Optometry

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Georgia Vision Center IncGroup PAC ID 8628148327, 3 clinicians

Practice addresses (Care Compare)

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.

• North Georgia Vision Center Inc

  • Optometrist
  • Rock Spring, GA
  • NPI 1952569279
  Medicare reassignment Care Compare group NPD
• Southeast Vision and Aesthetics

  • Optometrist
  • Rock Spring, GA
  • NPI 1386503670
  NPD Authorized official
• Eyecare Associates, P.C.

  • Optometrist
  • Hixson, TN
  • NPI 1669669107
  NPD (past)

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

{
    "created_epoch": "1682553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702166400000",
    "number": "1801584792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 BILTMORE DR",
            "city": "RINGGOLD",
            "state": "GA",
            "postal_code": "307363720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4511 HIXSON PIKE",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373435067",
            "telephone_number": "423-870-3742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEABOU",
        "first_name": "LYDIA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-27",
        "last_updated": "2023-12-10",
        "certification_date": "2023-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "3938",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "6400",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Derrick Gardner, R,PH
• Alexis Garduno
• Carlos Alberto Garrido
• Caroline Elisabeth Gates, NP-C
• Elizabeth A Gates, PMHNP-BC, LPC-MHSP
• Gentle Foot Care Inc
• Jeremy D German, PHARM D
• Devon Ghodasra, M.D.
• Kristina Gibbs, SLP-A
• Larry Gibson, MD

• Optometrist in Hixson, TN
• Providers in Hixson, TN by specialty
• Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.