Susan Gresham, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618002780 Issued in VA

Practice address

1500 Commerce Rd
Staunton, VA 24401-9032

Phone

(540) 213-7720

Fax

(540) 213-9441

NPI assigned

Apr 28, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Optometry

Education

Pennsylvania College of Optometry, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eyeone PLCGroup PAC ID 7416917554, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: susan.gresham.p1@direct.eyeone.nextgenshare.com

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.

• Eye One, PLC

  • Ophthalmology Physician
  • Charlottesville, VA
  • NPI 1982613576

  Optometrist, VA

  Medicare reassignment Care Compare group NPD
• Eyeone PLC

  • Durable Medical Equipment & Medical Supplies
  • Fishersville, VA
  • NPI 1497931273
  Care Compare group
• Augusta Eye Associates PLC

  • Durable Medical Equipment & Medical Supplies
  • Staunton, VA
  • NPI 1760668545
  NPD

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

{
    "created_epoch": "1556409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594080000000",
    "number": "1053975763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 N MEDICAL PARK DR",
            "city": "FISHERSVILLE",
            "state": "VA",
            "postal_code": "229392344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 COMMERCE RD",
            "city": "STAUNTON",
            "state": "VA",
            "postal_code": "244019032",
            "telephone_number": "540-213-7720",
            "fax_number": "540-213-9441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRESHAM",
        "first_name": "SUSAN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-28",
        "last_updated": "2020-07-07",
        "certification_date": "2020-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618002780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053975763",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittany Grant
• Robin Hensley Graves, PT
• Shenandoah Green, OTR/L
• Greenbrier Valley Physical Therapy LLC
• Richard Anthony Greene, MD
• Caitlin Griggs, COTA
• Jacqueline Groff, FNP
• Sarah Leanne Grow, PA-C
• Growing Forward LLC
• H. Lane Baggett, PH.D., LLC

• All providers in Staunton, VA
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2020; 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.