Bella Intellectum, LLC

Primary specialty

OpticianTaxonomy code 156FX1800X

License

LDO001395 Issued in GA

Legal business name

BELLA INTELLECTUM, LLC

Practice address

6803 Edmonton CT.
Lithonia, GA 30058

Phone

(404) 618-0212

NPI assigned

Jul 5, 2017

Organization subpart

No

Name

Ms. Deborah Woods Moody, LDONPI 1053832402

Title

Dispensing Optician/Manager

Phone

(404) 618-0212

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

• Deborah Woods Moody, LICENSED DISPENSING

  • Optician
  • Lithonia, GA
  • NPI 1053832402
  NPD (past) Authorized official

• Tots and Teens Optical Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 2, 2017.

{
    "created_epoch": "1499212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506902400000",
    "number": "1982125571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1483",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300584412",
            "telephone_number": "404-618-0212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6803 EDMONTON CT.",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "30058",
            "telephone_number": "404-618-0212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLA INTELLECTUM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-05",
        "last_updated": "2017-10-02",
        "status": "A",
        "authorized_official_last_name": "MOODY",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "WOODS",
        "authorized_official_title_or_position": "DISPENSING OPTICIAN/MANAGER",
        "authorized_official_telephone_number": "404-618-0212",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LDO"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "GA",
            "license": "LDO001395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tots and Teens Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Lithonia, GA
• Optician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2017; 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.