NPIMap

Organization Active NPI

Gary Wolf

  • Eyewear Supplier
  • Palmer, MA
National Provider Identifier
1306015045
Registry record updated Mar 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
2853 Issued in MA
Legal business name
GARY WOLF
Practice address
1140 Thorndike St
Palmer, MA 01069-1509
Phone
(413) 283-2946
Fax
(413) 283-3631
NPI assigned
Feb 27, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2008

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

Authorized official

Name
Dr. Gary Wolf, O.DNPI 1366447039
Title
Optometrist
Phone
(413) 283-2946

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X 2853 MA Primary

Addresses

Primary practice location

1140 Thorndike St
Palmer, MA 01069-1509

Mailing address

1140 Thorndike St
PO Box 909
Palmer, MA 01069-1509
Phone (413) 283-2946

Other identifiers 1

IdentifierTypeStateIssuer
0338656MedicaidMA

National Provider Directory

National Provider Directory

Locations

1140 Thorndike St
Palmer, MA 01069
Phone (413) 283-2946

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1204070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204675200000",
    "number": "1306015045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 THORNDIKE ST",
            "address_2": "PO BOX 909",
            "city": "PALMER",
            "state": "MA",
            "postal_code": "010691509",
            "telephone_number": "413-283-2946",
            "fax_number": "413-283-3631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 THORNDIKE ST",
            "city": "PALMER",
            "state": "MA",
            "postal_code": "010691509",
            "telephone_number": "413-283-2946",
            "fax_number": "413-283-3631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY WOLF",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-27",
        "last_updated": "2008-03-05",
        "status": "A",
        "authorized_official_last_name": "WOLF",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "413-283-2946",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "MA",
            "license": "2853",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0338656",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmer, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 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.