Individual provider Active NPI

Terrence Gaddy, LDO

  • Optician
  • Mesa, AZ
National Provider Identifier
1134098924
Registry record updated Oct 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
LDO-2510I Issued in AZ
Practice address
857 N Dobson Rd
Mesa, AZ 85201-7585
Phone
(480) 668-6952
NPI assigned
Oct 31, 2025
Last updated
Oct 31, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X LDO-2510I AZ Primary

Addresses

Primary practice location

857 N Dobson Rd
Mesa, AZ 85201-7585

Mailing address

304 S 89TH St
Mesa, AZ 85208-2301
Phone (602) 391-7738

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
LDO-2510IAZMDOptician

NPI Registry JSON

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

{
    "created_epoch": "1761868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761868800000",
    "number": "1134098924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 S 89TH ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852082301",
            "telephone_number": "602-391-7738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "857 N DOBSON RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852017585",
            "telephone_number": "480-668-6952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GADDY",
        "first_name": "TERRENCE",
        "credential": "LDO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-10-31",
        "last_updated": "2025-10-31",
        "certification_date": "2025-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "AZ",
            "license": "LDO-2510I",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2025; 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.