Organization Active NPI

Gervais-Floyd, LTD

Doing business as Pearle Vision

  • Optometrist
  • Orland Park, IL
National Provider Identifier
1154441756
Registry record updated Apr 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
GERVAIS-FLOYD, LTD
Doing business as
Pearle Vision
Practice address
24 Orland Square Dr
Orland Park, IL 60462-3207
Phone
(708) 403-3555
NPI assigned
Mar 29, 2007
Last updated
Apr 28, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2024

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

Authorized official

Name
Ms. Jennifer Sullivan
Title
Owner
Phone
(708) 403-3555

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X Primary
Eyewear Supplier 332H00000X

Addresses

Primary practice location

24 Orland Square Dr
Orland Park, IL 60462-3207

Mailing address

24 Orland Square Dr
Orland Park, IL 60462-3207
Phone (708) 403-3555

Other names 1

  • Pearle Vision Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130716000845 IL Part B Supplier - Clinic/Group Practice 7911147814 Receives reassigned benefits from 5 practitioners
Practice locations: Orland Park, IL

National Provider Directory

National Provider Directory
Tax ID family
Gervais - Floyd LTD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714262400000",
    "number": "1154441756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 ORLAND SQUARE DR",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604623207",
            "telephone_number": "708-403-3555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 ORLAND SQUARE DR",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604623207",
            "telephone_number": "708-403-3555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERVAIS-FLOYD, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2024-04-28",
        "certification_date": "2024-04-28",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-403-3555",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pearle Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.