Robert S Gentile Enterprise PC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

ROBERT S GENTILE ENTERPRISE PC

Practice address

1701 Boulevard SQ
Ste C
Waycross, GA 31501-8021

Phone

(912) 283-7171

Fax

(912) 284-9183

NPI assigned

Jan 11, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Robert S Gentile, O.D.NPI 1932194313

Title

Owner

Phone

(912) 283-7171

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert Smith Gentile, OD

  • Optometrist
  • Waycross, GA
  • NPI 1932194313
  NPD (past) Authorized official
• Diane Lynn Kapadia, OD

  • Optometrist
  • St Augustine, FL
  • NPI 1760471668
  NPD (past)

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

{
    "created_epoch": "1263168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277251200000",
    "number": "1063742245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 BOULEVARD SQ",
            "address_2": "STE C",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315018021",
            "telephone_number": "912-283-7171",
            "fax_number": "912-284-9183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 BOULEVARD SQ",
            "address_2": "STE C",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315018021",
            "telephone_number": "912-283-7171",
            "fax_number": "912-284-9183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT S GENTILE ENTERPRISE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-11",
        "last_updated": "2010-06-23",
        "status": "A",
        "authorized_official_last_name": "GENTILE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-283-7171",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115254692D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115254692C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jana Revels, NP
• Cullee Peavey Richardson, PA-C
• David A Rios, PA
• Yolanda L Rivers, PHARMD
• April Roberson
• Robert T Stark MD,PC
• Alice Faye Robinson, LPN
• Krystal Nakita Robinson, LMFT
• David Samuel Roth, M.D.
• William Monroe Rouse Jr., APRN-BC

• Optometrist in Waycross, GA
• Providers in Waycross, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.

Verify at the official NPI Registry.