Raymond Gary Poole, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1282 Issued in SC

Practice address

1115 W Floyd Baker Blvd
Gaffney, SC 29341-1411

Phone

(864) 487-2020

Fax

(864) 487-3510

NPI assigned

Jul 18, 2006

Last updated

May 4, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Dr. R. Gary Poole Other name

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Anthony J. Callan O.D., L.L.C.

  dba Dr. Callan's Family Eye Care

  • Eyewear Supplier
  • Easton, PA
  • NPI 1770752669
  NPD (past)

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493856000000",
    "number": "1275552572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 SUMMERLIGHT DR",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "295767232",
            "telephone_number": "843-651-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 W FLOYD BAKER BLVD",
            "city": "GAFFNEY",
            "state": "SC",
            "postal_code": "293411411",
            "telephone_number": "864-487-2020",
            "fax_number": "864-487-3510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POOLE",
        "first_name": "RAYMOND",
        "middle_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2017-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1282",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000142",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTRA",
            "identifier": "29580",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D12822",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "SC9828",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "R. GARY",
            "last_name": "POOLE",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Piedmont Medical of SC LLC
• Pamela Jean Pingitore, LMBT
• Poole Family Eye Care LLC
• Poole Family Eye Care of Gaffney LLC
• Nikki Vess Poole
• Kevin Porter
• Premise Health of South Carolina Medical PC (DTNA - Gaffney)
• Premise Health of South Carolina Medical, P.C (DTNA Occ - Gaffney)
• Premium Home Care Services LLC
• Prescriptions Plus Pharmacy, LLC

• Optometrist in Gaffney, SC
• Providers in Gaffney, SC by specialty
• Optometrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.