Nancy Tran Phan Gauthier, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1108 Issued in NV

Practice address

695 S Green Valley Pkwy
Henderson, NV 89052-0404

Phone

(702) 407-2455

NPI assigned

Apr 1, 2019

Last updated

Nov 2, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Nancy Tran Phan Former name

Medicare fee-for-service enrollment

Enrolled in NV, TX2 enrollments

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 2

Specialty

Optometry

Education

University of the Incarnate Word School of Osteo Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

John Chan OD PLLCGroup PAC ID 1052736345, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• John Chan O.D. PLLC

  dba Arclight Eye Care

  • Optometrist
  • Henderson, NV
  • NPI 1588295331
  Medicare reassignment Care Compare group NPD
• Angelo Eye Associates PA

  dba Advanced Eye Care

  • Optometrist
  • San Angelo, TX
  • NPI 1366591539
  Medicare reassignment NPD
• America's Best Contacts & Eyeglasses

  • Optician
  • Montgomery, AL
  • NPI 1902040488
  NPD (past)

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

{
    "created_epoch": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1013479054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "695 S GREEN VALLEY PKWY",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890520404",
            "telephone_number": "702-407-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "695 S GREEN VALLEY PKWY",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890520404",
            "telephone_number": "702-407-2455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUTHIER",
        "first_name": "NANCY",
        "middle_name": "TRAN PHAN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-01",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "9807",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "R-283-TA-B89",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "1108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NANCY",
            "last_name": "PHAN",
            "middle_name": "TRAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Robert A Gatlin, MD
• Codi Gauci
• Tim Gauci
• Marissa Gaut, BCBA, LBA
• Gautham Gummadi Reddy MD Limited
• Bindu Gaye
• Cynthia Nichol Gaytan, M.A, CPHW,SW,PHN
• Guadalupe Gaytan, DOTL/R
• Jewlisa Serina Gaytan
• Jessica L Gdovin, PA-C

• Optometrist in Henderson, NV
• Providers in Henderson, NV by specialty
• Optometrist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.