Garth A Court, OPTICIAN

Primary specialty

OpticianTaxonomy code 156FX1800X

License

4388 Issued in NY

Practice address

204 Main St Shop Centre
Waterloo, NY 13165

Phone

(315) 539-1209

Fax

(315) 539-1209

NPI assigned

Nov 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Waterloo Ophthalmic Dispensing, PC

  • Eyewear Supplier
  • Waterloo, NY
  • NPI 1518199371
  NPD (past)

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508932229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 MAIN ST SHOP CENTRE",
            "city": "WATERLOO",
            "state": "NY",
            "postal_code": "13165",
            "telephone_number": "315-539-1209",
            "fax_number": "315-539-1209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 MAIN ST SHOP CENTRE",
            "city": "WATERLOO",
            "state": "NY",
            "postal_code": "13165",
            "telephone_number": "315-539-1209",
            "fax_number": "315-539-1209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COURT",
        "first_name": "GARTH",
        "middle_name": "A",
        "credential": "OPTICIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NY",
            "license": "4388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "103006CT",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patrick Michael Clark, LMSW
• Ashley Coffey
• Kimberly Elaine Cohens, LPN
• Loreli Louise Connors, RN
• Joanne Farula Corey, SPEECH-LANGUAGE PATH
• Destinee Creeley
• Bryan D'Aoust, D.C.
• Patricia M D'Arduini, INTERN
• Lisa Depalma
• Robert Edward Dinan Jr., MSW, LCSW-R

• Optician in Waterloo, NY
• Providers in Waterloo, NY by specialty
• Optician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.