Active NPI
Gary E Roquemore, OD
- Optometrist
- Jasper, AL
National Provider Identifier
1013905637
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- S438TA078
- Practice address
- 904 Highway 78 E
Jasper, AL 35501-3957 - Phone
- (205) 221-6718
- Fax
- (205) 221-7578
- NPI assigned
- Oct 7, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | S438TA078 | AL | Primary |
Addresses
Primary practice location
904 Highway 78 E
Jasper, AL 35501-3957
Mailing address
904 Highway 78 E
Jasper, AL 35501-3957
Phone (205) 221-6718
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128643200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277424000000",
"number": "1013905637",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "904 HIGHWAY 78 E",
"city": "JASPER",
"state": "AL",
"postal_code": "355013957",
"telephone_number": "205-221-6718",
"fax_number": "205-221-7578"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "904 HIGHWAY 78 E",
"city": "JASPER",
"state": "AL",
"postal_code": "355013957",
"telephone_number": "205-221-6718",
"fax_number": "205-221-7578"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROQUEMORE",
"first_name": "GARY",
"middle_name": "E",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-07",
"last_updated": "2010-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "AL",
"license": "S438TA078",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jasper, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.