Optique Sandy Springs, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT001083 Issued in GA

Legal business name

OPTIQUE SANDY SPRINGS, LLC

Practice address

5940 Roswell Rd
Atlanta, GA 30328-4908

Phone

(678) 939-2709

Fax

(404) 601-0795

NPI assigned

Feb 25, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Peter J Moresi, O.D.

Title

President/Sole Member

Phone

(678) 939-2709

Specialties & licenses 2

Addresses

Other names 1

• Optique Atlanta Doing business as

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

{
    "created_epoch": "1393286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393286400000",
    "number": "1821413006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5940 ROSWELL RD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303284908",
            "telephone_number": "678-939-2709",
            "fax_number": "404-601-0795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5940 ROSWELL RD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303284908",
            "telephone_number": "678-939-2709",
            "fax_number": "404-601-0795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIQUE SANDY SPRINGS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-25",
        "last_updated": "2014-02-25",
        "status": "A",
        "authorized_official_last_name": "MORESI",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT/SOLE MEMBER",
        "authorized_official_telephone_number": "678-939-2709",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT001083",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002496",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optique Atlanta",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2014; 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.