Richard Dean Grossnickle, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

E6388 Issued in TX

Practice address

2615 NE Loop 286
Paris, TX 75460-3444

Phone

(906) 785-0083

Fax

(903) 785-2947

NPI assigned

Sep 7, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300665600000",
    "number": "1003800079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 NE LOOP 286",
            "city": "PARIS",
            "state": "TX",
            "postal_code": "754603444",
            "telephone_number": "906-785-0083",
            "fax_number": "903-785-2947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 NE LOOP 286",
            "city": "PARIS",
            "state": "TX",
            "postal_code": "754603444",
            "telephone_number": "906-785-0083",
            "fax_number": "903-785-2947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSNICKLE",
        "first_name": "RICHARD",
        "middle_name": "DEAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-07",
        "last_updated": "2011-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "E6388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110097602",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD TX",
            "identifier": "00SC11",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark W. Greenwell, M.D.
• Kastley Greer
• Theresa Greineder
• Stephanie Ruth Griffin, MS LMFT
• Vivian Griffith, M.S., CCC-SLP
• Shelly Renee Guthrie, PHARM.D.
• Stephanie Nicole Guzman, APRN, FNP-C
• H & H Partners Inc.
• Phillip Darryl Haage, RPH
• Kenneth Shane Halcomb, PT

• Ophthalmology Physician in Paris, TX
• Providers in Paris, TX by specialty
• Ophthalmology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.