Individual provider Active NPI

Gordon Vincent Culp Jr., O.D.

  • Optometrist
  • Ashburn, VA
National Provider Identifier
1003879834
Registry record updated Jan 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618000034 Issued in VA
Practice address
44727 Brimfield Dr
Ashburn, VA 20147-5920
Phone
(571) 385-4600
Fax
(571) 385-4605
NPI assigned
Apr 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618000034 VA Primary

Addresses

Primary practice location

44727 Brimfield Dr
Ashburn, VA 20147-5920

Mailing address

1950 Old Gallows Rd
Suite 520
Vienna, VA 22182-3990
Phone (703) 847-8899

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071106000211 VA Practitioner - Optometry 9830286947 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0618000034VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Virginia PLLC Optometrist CurrentSince Oct 31, 2014 Accepting new patients
Myeyedr Optometry of Virginia, PLLC Optometrist CurrentSince Oct 31, 2014 Accepting new patients
Lifetime Vision& Contacts P.C. CurrentSince Jan 4, 2007 Accepting new patients
Dulles Optometry, LLC Optometrist CurrentSince Oct 31, 2014 Accepting new patients
Myeyedr Optometry of Virginia PLLC Optometrist PastSince Jan 4, 2007 Accepting new patients

Locations

44727 Brimfield Dr
Ashburn, VA 20147
Phone (571) 385-4600

44345 Premier Plz
Ste 100
Ashburn, VA 20147
Phone (703) 729-8393

617 Potomac Station Dr NE
#A
Leesburg, VA 20176
Phone (703) 669-4646

22000 Dulles Retail Plz
Ste 168
Sterling, VA 20166
Phone (703) 421-3322

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516838400000",
    "number": "1003879834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD",
            "address_2": "SUITE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823990",
            "telephone_number": "703-847-8899",
            "fax_number": "703-991-0514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44727 BRIMFIELD DR",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201475920",
            "telephone_number": "571-385-4600",
            "fax_number": "571-385-4605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULP",
        "first_name": "GORDON",
        "middle_name": "VINCENT",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2018-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618000034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashburn, VA

Sources for this page

Verify at the official NPI Registry.