Xperience Drevagee

Primary specialty

OpticianTaxonomy code 156FX1800X

Legal business name

XPERIENCE DREVAGEE

Doing business as

drevagee optical boutique

Practice address

5745 Wendy Bagwell Pkwy Ste 32
Hiram, GA 30141-2885

Phone

(678) 522-1093

NPI assigned

Jun 2, 2023

Organization subpart

No

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

Authorized official

Name

Jeffrey Knowlin

Title

Ceo

Phone

(678) 522-1093

Specialties & licenses 1

Addresses

Other names 1

• drevagee optical boutique Doing business as

Locations

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

{
    "created_epoch": "1685664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685664000000",
    "number": "1851084933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2451 CUMBERLAND PKWY SE STE 3809",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303396136",
            "telephone_number": "678-522-1093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5745 WENDY BAGWELL PKWY STE 32",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301412885",
            "telephone_number": "678-522-1093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "XPERIENCE DREVAGEE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-02",
        "last_updated": "2023-06-02",
        "certification_date": "2023-06-02",
        "status": "A",
        "authorized_official_last_name": "KNOWLIN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "678-522-1093"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "drevagee optical boutique",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Katherine Wilson, PT
• Tabitha Wilson
• Robin Wingate, LCSW
• Angela Wingers, LPC
• Ashleigh Woods
• Jessica Yawn, RPH

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2023; 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.