Gateway Vision, Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC0002051 Issued in FL

Legal business name

GATEWAY VISION, INC

Practice address

5238-17 Norwood Ave
Jacksonville, FL 32208-5005

Phone

(904) 768-9196

Fax

(904) 765-4301

NPI assigned

Mar 5, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Richard Scott Grimshaw, O.D.NPI 1912963877

Title

Owner

Phone

(904) 768-9196

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Gateway Vision Inc

  • Optometrist
  • Atlantic Beach, FL
  • NPI 1205885886

  O20060602000127

  Same enrollment
• Gateway Vision Inc

  • Optometrist
  • Jacksonville, FL
  • NPI 1740548767

  O20060602000127

  Same enrollment

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Richard Scott Grimshaw, O.D.

  • Optometrist
  • Jacksonville, FL
  • NPI 1912963877
  NPD (past) Authorized official
• Amanda Rose Kovacs, O.D.

  • Optometrist
  • Atlantic Beach, FL
  • NPI 1588199806
  NPD (past)
• Mark Alan Popp, O.D.

  • Optometrist
  • Atlantic Beach, FL
  • NPI 1225089295
  NPD (past)

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

{
    "created_epoch": "1204675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204675200000",
    "number": "1447420443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5238-17 NORWOOD AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322085005",
            "telephone_number": "904-768-9196",
            "fax_number": "904-765-4301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5238-17 NORWOOD AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322085005",
            "telephone_number": "904-768-9196",
            "fax_number": "904-765-4301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWAY VISION, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-05",
        "last_updated": "2008-03-05",
        "status": "A",
        "authorized_official_last_name": "GRIMSHAW",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-768-9196",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC0002051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gateway Community Services, Inc.
• Gateway Community Services, Inc.
• Gateway Community Services, Inc.
• Gateway Homecare Services, LLC
• Gateway Vision Inc
• Lauren Elizabeth Gatewood, MD
• Miranda Marie Gatlin, ARNP
• Tatyana Enjanee Gatlin, RBT
• Robert S Gatling, DDS
• Christine C. Gatzke, LMT

• Optometrist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Optometrist in Florida

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.