Individual provider Active NPI

Leslie W Guy, O.D.

  • Optometrist
  • Woodstock, GA
National Provider Identifier
1952458804
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT002098 Issued in GA
Practice address
140 Woodstock Square Ave
Woodstock, GA 30189-6500
Phone
(678) 445-5561
NPI assigned
Jan 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT002098 GA Primary

Addresses

Primary practice location

140 Woodstock Square Ave
Woodstock, GA 30189-6500

Mailing address

217 Wild Turkey RDG
Ball Ground, GA 30107-4279
Phone (770) 735-3858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20150702001433 MN Practitioner - Optometry 0446206247 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Visionary Eye Care PAGroup PAC ID 9032455936, 13 clinicians

Practice addresses (Care Compare)

7000 York Ave S
Edina, MN 55435-4213
Phone (952) 922-8118

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT002098GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Visionary Eye Care, PA Optometrist CurrentSince Jul 27, 2022 Accepting new patients

Locations

810 County Road 42 W
Burnsville, MN 55337
Phone (952) 236-3003

11990 Business Park Blvd N
Champlin, MN 55316
Phone (763) 354-1006

851 W 78th St
Chanhassen, MN 55317
Phone (952) 252-1208

18275 Kenrick Ave
Lakeville, MN 55044
Phone (952) 892-0028

7000 York Ave S
Minneapolis, MN 55435
Phone (952) 922-8118

15800 87th St NE
Otsego, MN 55330
Phone (763) 252-1316

6445 Richfield Pkwy
Richfield, MN 55423
Phone (612) 243-0201

21615 S Diamond Lake Rd
Rogers, MN 55374
Phone (763) 428-4831

8900 Highway 7
St Louis Park, MN 55426
Phone (952) 933-4858

Organizations & group practices 1

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": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952458804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 WILD TURKEY RDG",
            "city": "BALL GROUND",
            "state": "GA",
            "postal_code": "301074279",
            "telephone_number": "770-735-3858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 WOODSTOCK SQUARE AVE",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301896500",
            "telephone_number": "678-445-5561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUY",
        "first_name": "LESLIE",
        "middle_name": "W",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

Verify at the official NPI Registry.