Active NPI
Regina D Gentile Johnston, OD
- Optometrist
- Orange, CT
National Provider Identifier
1043389851
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- CT840
- Practice address
- 501 Boston Post Rd
Orange, CT 06477 - Phone
- (203) 795-3937
- Fax
- (203) 891-0737
- NPI assigned
- Nov 7, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 | CT840 | CT | Primary |
Addresses
Primary practice location
501 Boston Post Rd
Orange, CT 06477
Mailing address
501 Boston Post Rd
Orange, CT 06477
Phone (203) 795-3937
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004068391 | Medicaid | CT |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CT840 | CT | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321401600000",
"number": "1043389851",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 BOSTON POST RD",
"city": "ORANGE",
"state": "CT",
"postal_code": "06477",
"telephone_number": "203-795-3937",
"fax_number": "203-891-0737"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 BOSTON POST RD",
"city": "ORANGE",
"state": "CT",
"postal_code": "06477",
"telephone_number": "203-795-3937",
"fax_number": "203-891-0737"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GENTILE JOHNSTON",
"first_name": "REGINA",
"middle_name": "D",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-07",
"last_updated": "2011-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CT",
"license": "CT840",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004068391",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Orange, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 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.