DR. STACI HARWELL TEBBETTS (NPI# 1417485715) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417485715 |
| Entity Type | Individual |
| Full Name | DR. STACI HARWELL TEBBETTS |
| Credential | OD |
| Practice Address |
279 N Broad St Ste C Winder GA 30680 |
| Mailing Address |
279 N Broad St Ste C Winder GA 30680-2589 |
| Practice Telephone | (770) 867-2505 |
| Practice Fax Number | 7708678668 |
| Mailing Telephone | 7708672505 |
| Mailing Fax Number | 7708678668 |
| Enumeration Date | 2017-05-31 |
| Last Update Date | 2018-07-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | OPT003012 | GA | Eye and Vision Services Providers |
| Street Address |
279 N BROAD ST STE C |
| City | WINDER |
| State | GA |
| Zip Code | 30680 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326520776 | Alexandrea Hosch | Specialist/Technologist | 474 Lisa Circle, Winder, GA 30680 | 2018-09-02 |
| 1427574185 | Kristen Layfield Harbin | Dietitian, Registered | 827 Jefferson Hwy, Winder, GA 30680 | 2017-08-15 |
| 1609234947 | Carmichaels Home Medical Equipment Inc | Durable Medical Equipment & Medical Supplies | 289 N Broad St, Winder, GA 30680 | 2016-02-02 |
| 1699140434 | Chee Vang | Physical Therapy Assistant | 1012 Bowman Way, Winder, GA 30680 | 2015-12-04 |
| 1518361989 | Usrc Winder, LLC | Clinic/Center | 429 Loganville Hwy Ste 105-109, Winder, GA 30680 | 2014-10-14 |
| 1871901090 | Carol Lumpkin | Nurse Practitioner | 15 Porter St East, Winder, GA 30680 | 2014-07-31 |
| 1548501851 | Jennifer Won | Dentist | 444 Atlanta Hwy Nw Ste 500, Winder, GA 30680 | 2013-03-12 |
| 1801041595 | Joan Theresa James | Obstetrics & Gynecology | 137 W Athens St Ste 103, Winder, GA 30680 | 2008-11-21 |
| 1669636767 | Lee Lindsey Bleshoy | Nurse Practitioner | 133 W Athens St Ste A, Winder, GA 30680 | 2008-07-17 |
| 1083836977 | Jeffrey Todd Miller | Chiropractor | 257 N. Broad Street, Winder, GA 30680 | 2007-05-02 |
| Find all providers in zip 30680 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265526842 | Pamela S Gewirtz | Optometrist | 440 Atlanta Hwy, Winder, GA 30024 | 2006-10-03 |
| 1154349041 | Winder Eye Care Center | Optometrist | 279 N Broad St, Suite C, Winder, GA 30680-2583 | 2006-07-18 |
| 1679577258 | Darrell Allen Sorah Jr. | Optometrist | 90 Church St, Winder, GA 30680-1714 | 2005-06-10 |
| 1972750842 | Cara Patterson Robison | Optometrist | 72 W Candler St, Winder, GA 30680-2557 | 2008-08-22 |
| 1801063680 | Michael L Serrano Od | Optometrist | 440 Atlanta Hwy Nw, Winder, GA 30680-7826 | 2008-05-12 |
| 1922272020 | J-christy Inc | Optometrist | 135 N Broad St, Winder, GA 30680-2110 | 2008-04-18 |
| 1346211679 | Karen M Canupp | Optometrist | 90 Church St, Winder, GA 30680-1714 | 2006-01-26 |
| 1730183351 | Mark W Hall | Optometrist | 90 Church St, Winder, GA 30680-1714 | 2005-06-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447850466 | Kelsea Brown | Optometrist | 2184 Henderson Mill Rd Ne Ste 12b, Atlanta, GA 30345-3762 | 2020-10-28 |
| 1437756459 | Atl Optical LLC | Optometrist | 9380 The Landing Dr Ste B, Douglasville, GA 30135-7177 | 2020-10-02 |
| 1831703289 | First Class Eye Care, LLC | Optometrist | 2730 Peachtree Industrial Blvd Ste 206, Duluth, GA 30097-8628 | 2020-09-03 |
| 1770196636 | Orbic Eye Care | Optometrist | 339 Furys Ferry Rd Ste 1, Martinez, GA 30907-3072 | 2020-08-28 |
| 1154933877 | Atl Optical LLC | Optometrist | 3135 Highway 278 Ne, Covington, GA 30014 | 2020-08-24 |
| 1629680830 | Mobile Medical Eye Care LLC | Optometrist | 110 Moseley Crossing Dr, Stockbridge, GA 30281-6501 | 2020-08-19 |
| 1376154963 | Family First Vision Care Georgia | Optometrist | 1401 Johnson Ferry Rd Ste 148b, Marietta, GA 30062-6499 | 2020-08-17 |
| 1740890284 | Woodstock Eye Associates LLC | Optometrist | 113 Lincoln St, Woodstock, GA 30188-7800 | 2020-08-07 |
| 1770101818 | Tony Lam | Optometrist | 2549 Piedmont Rd Ne Ste 120, Atlanta, GA 30324-3023 | 2020-07-06 |
| 1619594561 | Steven Nguyen | Optometrist | 1905 Scenic Hwy S #1130, Snellville, GA 30078 | 2020-06-26 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.