NPIMap

Organization Active NPI

Eca Optical, LLC

  • Eyewear Supplier
  • Fayetteville, GA
National Provider Identifier
1912396276
Registry record updated Jan 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
LDO000890 Issued in GA
Legal business name
ECA OPTICAL, LLC
Practice address
340 Brandywine Blvd
Fayetteville, GA 30214-1562
Phone
(770) 460-4286
NPI assigned
Jan 9, 2015
Organization subpart
Yes
Parent organization
EYE CONSULTANTS OF ATLANTAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 9, 2015

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

Authorized official

Name
Kimberly Perry
Title
Credentialing Coordinator
Phone
(404) 351-2220

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X LDO000890 GA Primary

Addresses

Primary practice location

340 Brandywine Blvd
Fayetteville, GA 30214-1562

Mailing address

3225 Cumberland Blvd SE
Ste 900
Atlanta, GA 30339-6407
Phone (404) 351-2220

National Provider Directory

National Provider Directory
Part of
Anthony P Johnson MD

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

340 Brandywine Blvd
Fayetteville, GA 30214
Phone (770) 460-4286

601 Professional Dr
Ste 170
Lawrenceville, GA 30046
Phone (404) 423-7112

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1420761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420761600000",
    "number": "1912396276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3225 CUMBERLAND BLVD SE",
            "address_2": "STE 900",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303396407",
            "telephone_number": "404-351-2220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 BRANDYWINE BLVD",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141562",
            "telephone_number": "770-460-4286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ECA OPTICAL, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EYE CONSULTANTS OF ATLANTA",
        "enumeration_date": "2015-01-09",
        "last_updated": "2015-01-09",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "404-351-2220"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "GA",
            "license": "LDO000890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2015; 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.