Active NPI
Kurt W Guelzow, MD
- Ophthalmology Physician
- Roanoke, VA
National Provider Identifier
1295739852
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 0101030032
- Practice address
- 707 S Jefferson St
Roanoke, VA 24016-5100 - Phone
- (540) 855-5100
- NPI assigned
- Jun 10, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 0101030032 | VA | Primary |
Addresses
Primary practice location
707 S Jefferson St
Roanoke, VA 24016-5100
Mailing address
PO Box 1789
Roanoke, VA 24008-1789
Phone (540) 855-5100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 006377921 | Medicaid | VA |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101030032 | VA | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1258588800000",
"number": "1295739852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1789",
"city": "ROANOKE",
"state": "VA",
"postal_code": "240081789",
"telephone_number": "540-855-5100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "707 S JEFFERSON ST",
"city": "ROANOKE",
"state": "VA",
"postal_code": "240165100",
"telephone_number": "540-855-5100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUELZOW",
"first_name": "KURT",
"middle_name": "W",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-10",
"last_updated": "2009-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "VA",
"license": "0101030032",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "006377921",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Roanoke, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.