Individual provider Active NPI

Rachel Gleason, OPTICIAN

  • Optician
  • Watertown, NY
National Provider Identifier
1174983068
Registry record updated Mar 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
009739 Issued in NY
Practice address
1815 State St
Watertown, NY 13601-9407
Phone
(315) 786-8064
Fax
(315) 788-1950
NPI assigned
Mar 4, 2016
Last updated
Mar 4, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 009739 NY Primary

Addresses

Primary practice location

1815 State St
Watertown, NY 13601-9407

Mailing address

1815 State St
Watertown, NY 13601-9407
Phone (315) 786-8064

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
009739NYMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1457049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457049600000",
    "number": "1174983068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 STATE ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136019407",
            "telephone_number": "315-786-8064",
            "fax_number": "315-788-1950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 STATE ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136019407",
            "telephone_number": "315-786-8064",
            "fax_number": "315-788-1950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLEASON",
        "first_name": "RACHEL",
        "credential": "OPTICIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-04",
        "last_updated": "2016-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NY",
            "license": "009739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2016; 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.