Bella Intellectum, LLC

Primary specialty

OpticianTaxonomy code 156FX1800X

License

LDO001395 Issued in GA

Legal business name

BELLA INTELLECTUM, LLC

Doing business as

Tots and Teens Optical

Practice address

6803 Edmonton CT.
Lithonia, GA 30058

Phone

(404) 618-0212

NPI assigned

Jul 5, 2017

Last updated

Oct 2, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Deborah Woods Moody, LDONPI 1053832402

Title

Dispensing Optician/Manager

Phone

(404) 618-0212

Specialties & licenses 1

Addresses

Other names 1

• Tots and Teens Optical Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Deborah Woods Moody, LICENSED DISPENSING

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

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

{
    "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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• Optician in Lithonia, GA
• Providers in Lithonia, GA by specialty
• 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.