Active NPI
Douglas Henry Gratwohl, O.D.
- Optometrist
- Hardin, MT
National Provider Identifier
1508893694
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 431
- Practice address
- 215 W 3Rd Street
Hardin, MT 59034-1701 - Phone
- (406) 665-1204
- Fax
- (406) 665-4177
- NPI assigned
- Jun 26, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 431 | MT | Primary |
Addresses
Primary practice location
215 W 3Rd Street
Hardin, MT 59034-1701
Mailing address
215 W 3Rd Street
Hardin, MT 59034-1701
Phone (406) 665-1204
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 048-4185 | Medicaid | MT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shoptikal LLC | Optometrist | Current | Accepting new patients |
| Shoptikal LLC | Optometrist | Current | Accepting new patients |
Locations
316 S 24th St W
Ste B101
Billings, MT 59102
Phone (406) 652-7297
2510 S Reserve St
Missoula, MT 59801
Phone (406) 721-3789
3075 N Reserve St
Ste F
Missoula, MT 59808
Phone (406) 721-4646
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1269388800000",
"number": "1508893694",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "215 W 3RD STREET",
"city": "HARDIN",
"state": "MT",
"postal_code": "590341701",
"telephone_number": "406-665-1204",
"fax_number": "406-665-4177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 W 3RD STREET",
"city": "HARDIN",
"state": "MT",
"postal_code": "590341701",
"telephone_number": "406-665-1204",
"fax_number": "406-665-4177"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRATWOHL",
"first_name": "DOUGLAS",
"middle_name": "HENRY",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-26",
"last_updated": "2010-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MT",
"license": "431",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "048-4185",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hardin, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2010; 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.