Gary H Nelson, OPTICIAN

Primary specialty

OpticianTaxonomy code 156FX1800X

License

004127-1 Issued in NY

Practice address

707 Fairmount Ave
Suite 11
Jamestown, NY 14701-2623

Phone

(716) 483-1955

NPI assigned

Dec 5, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Hall Optical

  dba Gary H Nelson

  • Eyewear Supplier
  • Jamestown, NY
  • NPI 1831339639
  NPD (past) Authorized official

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320278400000",
    "number": "1033277629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 FAIRMOUNT AVE.",
            "address_2": "STE 11",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147012623",
            "telephone_number": "716-483-1955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 FAIRMOUNT AVE",
            "address_2": "SUITE 11",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147012623",
            "telephone_number": "716-483-1955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "GARY",
        "middle_name": "H",
        "name_prefix": "Mr.",
        "credential": "OPTICIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2011-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NY",
            "license": "004127-1",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NY",
            "license": "4127-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00622124",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Keiona Marie Nance
• Michael Navarro
• Barb Y Neal, PTA
• Donald Lawrence Nelson, DDS
• Emily Nelson, M.S. ED. CCC-SLP
• Gregory Scott Nelson, RPH
• Hillary Anne Nelson
• Jordan Paul Nelson, DC
• Kristopher E Nelson, NURSE PRACTITIONER
• Tracy Nelson

• Optician in Jamestown, NY
• Providers in Jamestown, NY by specialty
• Optician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.