MR. TERRELL THOMPSON UNDERWOOD (NPI# 1881729788) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881729788 |
| Entity Type | Individual |
| Full Name | MR. TERRELL THOMPSON UNDERWOOD |
| Credential | L.D.O. |
| Practice Address |
805 Commerce Dr Sw Suite A Conyers GA 30094-6606 |
| Practice Telephone | 7704834831 |
| Practice Fax Number | 7704834840 |
| Mailing Telephone | 7704834831 |
| Mailing Fax Number | 7704834840 |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 156FX1800X |
Technician/Technologist Specialization: Optician |
LDO000310 | GA | Eye and Vision Services Providers |
| Street Address |
805 COMMERCE DR SW SUITE A |
| City | CONYERS |
| State | GA |
| Zip Code | 30094-6606 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871530964 | Stacy U Carson | Optometrist | 805 Commerce Dr Sw, Suite A, Conyers, GA 30094-6606 | 2006-05-31 |
| 1447387774 | T. T Underwood, Inc. | Optometrist | 805 Commerce Dr Sw, Suite A, Conyers, GA 30094-6606 | 2007-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164029054 | Darlene Fletcher | Counselor | 827 St. Clair Dr., Conyers, GA 30094 | 2020-10-05 |
| 1194363366 | Clara A Matthews | Physician Assistant | 1930 Windsor Creek Drive Sw, Conyers, GA 30094 | 2019-12-18 |
| 1659838571 | Sensitive Home Care Agency Inc. | PACE Provider Organization | 2225 Morning Dew, Conyers, GA 30094 | 2019-02-27 |
| 1679097992 | Sheira Dennis | Case Management | 3828 Martingale Dr Se, Conyers, GA 30094 | 2017-07-28 |
| 1730571399 | Wellness and Trauma Recovery Center | Counselor | 1775 Parker Rd. Building C, Suite 210, Conyers, GA 30094 | 2015-02-19 |
| 1760870612 | Michael Terrell | Technician/Technologist | 806 Cambridge Creek Dr, Conyers, GA 30094 | 2014-12-30 |
| 1538567466 | Jennifer Angela Johnson | Registered Nurse | 2240 Wren Rd Se, Conyers, GA 30094 | 2014-12-09 |
| 1225445208 | Wanda Marcella Rainey-reed | Counselor | 1453 Klondike Rd Sw Ste D, Conyers, GA 30094 | 2014-07-22 |
| 1508155268 | Nicklaus Trent Rice | Obstetrics & Gynecology | 2750 Owens Dr, Conyers, GA 30094 | 2011-04-04 |
| 1720219660 | Candace Alexander | Dentist | 863 Flat Shoals Rd Se, Suite C #220, Conyers, GA 30094 | 2009-07-27 |
| Find all providers in zip 30094 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720451552 | National Vision, Inc. | Technician/Technologist | 1596 Dogwood Dr Se, Ste D, Conyers, GA 30013-5072 | 2015-11-02 |
| 1760870612 | Michael Terrell | Technician/Technologist | 806 Cambridge Creek Dr, Conyers, GA 30094 | 2014-12-30 |
| 1649354259 | Wal-mart Stores East, Lp | Technician/Technologist | 1436 Dogwood Dr Se, Conyers, GA 30013-5098 | 2006-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427667302 | Carole F Medou | Technician/Technologist | 57 Hurricane Shoals Rd Nw Ste A, Lawrenceville, GA 30046-5396 | 2020-07-28 |
| 1255966206 | Steven W Burton | Technician/Technologist | 2498 Wingfield Dr, Austell, GA 30106-1762 | 2020-03-10 |
| 1477185205 | Dale A Klauss | Technician/Technologist | 294 Kenwood Rd Ste A, Fayetteville, GA 30214-3451 | 2020-02-10 |
| 1104380682 | National Vision Inc | Technician/Technologist | 97 Parkway Dr, Fort Oglethorpe, GA 30742-4249 | 2019-01-29 |
| 1134683600 | National Vision Inc | Technician/Technologist | 3159 Highway 278 Ne, Covington, GA 30014-2301 | 2019-01-29 |
| 1255818993 | Kerryn Castellon | Technician/Technologist | 55 Sudderth St, Buford, GA 30518-3335 | 2018-07-25 |
| 1770075731 | National Vision, Inc. | Technician/Technologist | 916 Loganville Hwy Ste 300, Bethlehem, GA 30620-2145 | 2018-06-05 |
| 1598262487 | National Vision, Inc. | Technician/Technologist | 534 Marketplace Pkwy Ste 740, Dawsonville, GA 30534-7549 | 2018-04-09 |
| 1720582992 | Amos D Washington | Technician/Technologist | 10269 Industrial Blvd Ne, Covington, GA 30014-1485 | 2018-03-21 |
| 1619490489 | Lisa Stonebraker | Technician/Technologist | 105 E Main St Ste 116, Woodstock, GA 30188-5013 | 2017-07-24 |
| 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.