Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mystic Medical, LLC

Organization Optometrist · NPI 1093108763

Mystic Medical, LLC is an Optometrist in Atlanta, Georgia. Registered with an NPI since 2015.

In the registry since
2015
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

5555 Glenridge Connector Ste 200
Atlanta, GA 30342-4759
Phone: (404) 351-0055
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Foot & Ankle Surgery Podiatrist (primary) Taxonomy 213ES0103X
Optometrist Taxonomy 152W00000X

Record details

NPI number1093108763
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Amanda Dykes — Admin · (404) 351-0055
NPI enumeratedMarch 5, 2015
Last updated in NPPESMarch 25, 2025
Certification dateMarch 25, 2025
Mailing address5555 Glenridge Connector, Suite 200, Atlanta, GA 30342-4759

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