Individual provider Active NPI

Erin Elizabeth Gates, OD

  • Optometrist
  • Jacksonville, FL
National Provider Identifier
1255825709
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2072 Issued in SC
Practice address
2080 Child St
Jacksonville, FL 32214-5005
Phone
(803) 435-2494
NPI assigned
Jun 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2072 SC Primary

Addresses

Primary practice location

2080 Child St
Jacksonville, FL 32214-5005

Mailing address

2080 Child St
Jacksonville, FL 32214-5005

Other names 1

  • Erin E Walsh Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180807000054 SC Practitioner - Optometry 8224386313 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2072SCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Associates of Columbia Inc CurrentSince Aug 28, 2020 Accepting new patients

Locations

100 Columbiana Cir
Ste 1154
Columbia, SC 29212
Phone (803) 781-1669

470 Town Center Pl
Ste 5
Columbia, SC 29229
Phone (803) 784-2010

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1529366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1255825709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 CHILD ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322145005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 CHILD ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322145005",
            "telephone_number": "803-435-2494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATES",
        "first_name": "ERIN",
        "middle_name": "ELIZABETH",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-19",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "2072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "WALSH",
            "middle_name": "E",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.