Active NPI
Earnest Lee Cardwell, O.D.
- Optometrist
- Rome, GA
National Provider Identifier
1962597443
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1134T
- Practice address
- 2510 Redmond Circle
Rome, GA 30165 - Phone
- (706) 290-9950
- NPI assigned
- Oct 3, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1134T | GA | Primary |
Addresses
Primary practice location
2510 Redmond Circle
Rome, GA 30165
Mailing address
2188 East Broomtown Road
Lafayette, GA 30728
Phone (706) 638-7839
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00437148B | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1134T | GA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962597443",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2188 EAST BROOMTOWN ROAD",
"city": "LAFAYETTE",
"state": "GA",
"postal_code": "30728",
"telephone_number": "706-638-7839"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2510 REDMOND CIRCLE",
"city": "ROME",
"state": "GA",
"postal_code": "30165",
"telephone_number": "706-290-9950"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARDWELL",
"first_name": "EARNEST",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "GA",
"license": "1134T",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00437148B",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rome, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.