Individual provider Active NPI

Gretchen D Ariz, O.D.

  • Optometrist
  • Jber, AK
National Provider Identifier
1295874907
Registry record updated Jun 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
344 Issued in AK
Practice address
5955 Zeamer Ave
673D MDG
Jber, AK 99506-3702
Phone
(907) 580-1150
Fax
(907) 580-1152
NPI assigned
Feb 6, 2007
Last updated
Jun 20, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 344 AK Primary

Addresses

Primary practice location

5955 Zeamer Ave
673D MDG
Jber, AK 99506-3702

Mailing address

5955 Zeamer Ave
673D MDG
Jber, AK 99506-3702
Phone (907) 580-1150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
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
I20140815002201 AK Order and Referring Only - OptometryPractitioner - Optometry 2163649005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403222400000",
    "number": "1295874907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5955 ZEAMER AVE",
            "address_2": "673D MDG",
            "city": "JBER",
            "state": "AK",
            "postal_code": "995063702",
            "telephone_number": "907-580-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5955 ZEAMER AVE",
            "address_2": "673D MDG",
            "city": "JBER",
            "state": "AK",
            "postal_code": "995063702",
            "telephone_number": "907-580-1150",
            "fax_number": "907-580-1152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARIZ",
        "first_name": "GRETCHEN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2014-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AK",
            "license": "344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jber, AK

Sources for this page

Verify at the official NPI Registry.