Advanced Family Eyecare of Hampton, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT002401 Issued in GA

Legal business name

ADVANCED FAMILY EYECARE OF HAMPTON, LLC

Practice address

990 Bear Creek Blvd Ste D
Hampton, GA 30228-1864

Phone

(770) 707-0711

NPI assigned

Aug 28, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Crystal Gardner, ODNPI 1336349901

Title

Sole Managing Member

Phone

(770) 707-0711

Specialties & licenses 1

Addresses

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

• Crystal A Gardner, OD

  • Optometrist
  • Hampton, GA
  • NPI 1336349901

  GA, Optometrist

  Medicare reassignment NPD Authorized official
• Courtney Lam

  • Optometrist
  • Hampton, GA
  • NPI 1487577219
  NPD (past)

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

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

{
    "created_epoch": "1314489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314489600000",
    "number": "1942580428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 BEAR CREEK BLVD STE D",
            "city": "HAMPTON",
            "state": "GA",
            "postal_code": "302281864",
            "telephone_number": "770-707-0711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 BEAR CREEK BLVD STE D",
            "city": "HAMPTON",
            "state": "GA",
            "postal_code": "302281864",
            "telephone_number": "770-707-0711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED FAMILY EYECARE OF HAMPTON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-28",
        "last_updated": "2011-08-28",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "SOLE MANAGING MEMBER",
        "authorized_official_telephone_number": "770-707-0711",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandt Curtis Adams, D.C.
• Cozy Kenya Adams, LPN
• Sabrina Rae Adams, LMT
• Oluwaseyi Roseline Adeniji
• Adrienne Embry Ammons, D.D.S., P.C.
• Advanced Family Strategies LLC
• Olayinka Afon, NP
• Agape Home Care Services LLC
• Oluwadamilola M Akerele
• Pearl Augusta Akpaka

• All providers in Hampton, GA
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.