Individual provider Active NPI

Lauren Elizabeth Daniel, OD

  • Optometrist
  • Kennesaw, GA
National Provider Identifier
1881436210
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT003579 Issued in GA
Practice address
1415 Wooten Lake Rd NW
Kennesaw, GA 30144-1336
Phone
(770) 573-4345
NPI assigned
Jun 7, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT003579 GA Primary

Addresses

Primary practice location

1415 Wooten Lake Rd NW
Kennesaw, GA 30144-1336

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240806000517 GA Practitioner - Optometry 2961949128 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of Georgia, LLCGroup PAC ID 8224261201, 100 clinicians

Practice addresses (Care Compare)

1415 Wooten Lake Rd NW
Suite 100
Kennesaw, GA 30144-1342
Phone (770) 424-2020

4875 Altama Ave
Brunswick, GA 31520-2912
Phone (912) 554-0010

9801 Hwy 92
Suite 100
Woodstock, GA 30188-6454
Phone (770) 592-7100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT003579GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Georgia, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist CurrentSince Jul 23, 2024 Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist CurrentSince Jul 23, 2024 Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist Past Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist Past Accepting new patients

Locations

6121 Cedarcrest Rd NW
#108
Acworth, GA 30101
Phone (770) 529-7789

3975 Old Milton Pkwy
Ste 2
Alpharetta, GA 30005
Phone (678) 624-7766

860 Peachtree St NE
Ste F
Atlanta, GA 30308
Phone (404) 853-5008

3155 Cobb Pkwy SE
Ste 110
Atlanta, GA 30339
Phone (770) 644-0012

800 Peachtree St NE
Ste E1
Atlanta, GA 30308
Phone (678) 732-3432

4875 Altama Ave
Brunswick, GA 31520
Phone (912) 554-0010

217 Riverstone Dr
Canton, GA 30114
Phone (770) 345-5220

1409 Sixes Rd
Canton, GA 30114
Phone (770) 852-2733

123 W Main St
#A
Cartersville, GA 30120
Phone (470) 888-2044

335 W Ponce de Leon Ave
Ste F
Decatur, GA 30030
Phone (404) 377-3937

1415 Wooten Lake Rd NW
Ste 100
Kennesaw, GA 30144
Phone (770) 424-2020

1570 Old Alabama Rd
Ste 106
Roswell, GA 30076
Phone (770) 557-0039

250 E Crossville Rd
Roswell, GA 30075
Phone (770) 720-4449

9801 Highway 92
Ste 100
Woodstock, GA 30188
Phone (770) 592-7100

12924 Highway 92
Ste 100
Woodstock, GA 30188
Phone (678) 717-9121

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 5

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": "1717718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1881436210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 WOOTEN LAKE RD NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301441336",
            "telephone_number": "770-573-4345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIEL",
        "first_name": "LAUREN",
        "middle_name": "ELIZABETH",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-07",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

Verify at the official NPI Registry.