Individual provider Active NPI

Amber K Gunter, O.D.

  • Optometrist
  • Galax, VA
National Provider Identifier
1205006772
Registry record updated May 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618001708 Issued in VA
Practice address
1102 E Stuart Dr
Galax, VA 24333-2514
Phone
(276) 236-4171
Fax
(276) 236-0909
NPI assigned
Mar 11, 2008
Last updated
May 24, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618001708 VA Primary

Addresses

Primary practice location

1102 E Stuart Dr
Galax, VA 24333-2514

Mailing address

1102 E Stuart Dr
Galax, VA 24333-2514
Phone (276) 236-4171

Other identifiers 1

IdentifierTypeStateIssuer
1649206814OtherVAGROUP NPI

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
0618001708VAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1205193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306195200000",
    "number": "1205006772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 E STUART DR",
            "city": "GALAX",
            "state": "VA",
            "postal_code": "243332514",
            "telephone_number": "276-236-4171",
            "fax_number": "276-236-0909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 E STUART DR",
            "city": "GALAX",
            "state": "VA",
            "postal_code": "243332514",
            "telephone_number": "276-236-4171",
            "fax_number": "276-236-0909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNTER",
        "first_name": "AMBER",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-11",
        "last_updated": "2011-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001708",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1649206814",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Galax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2011; 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.