Shedena Taylor Roberts, LDO
Technician/Technologist, Optician in Leesburg, GA. Individual provider (NPI-1).
NPI number1013833656
StatusActive
Last updated in NPPESJun 27, 2026
Details
- NPI
- 1013833656
- Entity type
- Individual (NPI-1)
- Name
- Shedena Taylor Roberts
- Credential
- LDO
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 27, 2026
- Certification date
- Jun 27, 2026
- Last updated
- Jun 27, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 156FX1800X | Technician/Technologist, Optician | LDO001657 | GA | Yes |
Practice location
208 Lynwood LnLeesburg, GA 31763-4926
Phone 229-322-9595
Mailing address
208 Lynwood LnLeesburg, GA 31763-4926
Phone 229-322-9595
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