Individual provider Active NPI

Joni Lynn Gantt, O.D.

  • Optometrist
  • Chelsea, AL
National Provider Identifier
1124101811
Registry record updated Dec 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
S-B07-TA-703 Issued in AL
Practice address
16077 Highway 280
Chelsea, AL 35043-8410
Phone
(205) 678-0090
Fax
(205) 678-0705
NPI assigned
Oct 24, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC 004099 FL
Optometrist 152W00000X S-B07-TA-703 AL Primary

Addresses

Primary practice location

16077 Highway 280
Chelsea, AL 35043-8410

Mailing address

16077 Highway 280
Chelsea, AL 35043-8410
Phone (205) 678-0090

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
S-B07-TA-703ALMDOptometrist
OPC 004099FLMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291334400000",
    "number": "1124101811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16077 HIGHWAY 280",
            "city": "CHELSEA",
            "state": "AL",
            "postal_code": "350438410",
            "telephone_number": "205-678-0090",
            "fax_number": "205-678-0705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16077 HIGHWAY 280",
            "city": "CHELSEA",
            "state": "AL",
            "postal_code": "350438410",
            "telephone_number": "205-678-0090",
            "fax_number": "205-678-0705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANTT",
        "first_name": "JONI",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2010-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 004099",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S-B07-TA-703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chelsea, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.