Individual provider Active NPI

Rey Garrido, O.D.

  • Optometrist
  • Gastonia, NC
National Provider Identifier
1255324034
Registry record updated Mar 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1600 Issued in NC
Practice address
2325 Aberdeen Blvd
Gastonia, NC 28054-0614
Phone
(704) 853-3937
Fax
(704) 853-8029
NPI assigned
Aug 26, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1600 NC Primary

Addresses

Primary practice location

2325 Aberdeen Blvd
Gastonia, NC 28054-0614

Mailing address

2325 Aberdeen Blvd
Gastonia, NC 28054-0614
Phone (704) 853-3937

Other identifiers 4

IdentifierTypeStateIssuer
0936FOtherNCBLUE CROSS OF NC
19302OtherNCPARTNERS MEDICARE CHOICE
890936FMedicaidNC
66159OtherNCMEDCOST

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
1600NCMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205280000000",
    "number": "1255324034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2325 ABERDEEN BLVD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280540614",
            "telephone_number": "704-853-3937",
            "fax_number": "704-853-8029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2325 ABERDEEN BLVD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280540614",
            "telephone_number": "704-853-3937",
            "fax_number": "704-853-8029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRIDO",
        "first_name": "REY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-26",
        "last_updated": "2008-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF NC",
            "identifier": "0936F",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS MEDICARE CHOICE",
            "identifier": "19302",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890936F",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "66159",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2008; 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.