Gordon R. Boyd O.D.,P.C.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

0474130001 Issued in IN

Legal business name

GORDON R. BOYD O.D.,P.C.

Practice address

1485 S. Grant Ave
Suite a
Crawfordsville, IN 47933-3329

Phone

(765) 362-3209

Fax

(765) 364-9233

NPI assigned

Oct 5, 2007

Organization subpart

No

Name

Dr. Gordon R. Boyd, O.D.NPI 1427052216

Title

President/Optometrist

Phone

(765) 362-3209

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

• Gordon R Boyd, O.D.

  • Optometrist
  • Crawfordsville, IN
  • NPI 1427052216

  IN

  Medicare reassignment NPD Authorized official
• Grace Belangee, OD

  • Optometrist
  • Lafayette, IN
  • NPI 1891684551
  NPD (past)
• Grant Kenneth Lyons, OD

  • Optometrist
  • Lafayette, IN
  • NPI 1609618834
  NPD (past)

Medicare fee-for-service enrollment

Enrolled in IN

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 1, 2008.

{
    "created_epoch": "1191542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207008000000",
    "number": "1568650331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1485 S. GRANT AVE",
            "address_2": "SUITE A",
            "city": "CRAWFORDSVILLE",
            "state": "IN",
            "postal_code": "479333329",
            "telephone_number": "765-362-3209",
            "fax_number": "765-364-9233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1485 S. GRANT AVE",
            "address_2": "SUITE A",
            "city": "CRAWFORDSVILLE",
            "state": "IN",
            "postal_code": "479333329",
            "telephone_number": "765-362-3209",
            "fax_number": "765-364-9233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GORDON R. BOYD O.D.,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-05",
        "last_updated": "2008-04-01",
        "status": "A",
        "authorized_official_last_name": "BOYD",
        "authorized_official_first_name": "GORDON",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT/OPTOMETRIST",
        "authorized_official_telephone_number": "765-362-3209",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IN",
            "license": "0474130001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VSP",
            "identifier": "U25862",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiffani Gibson, RBT
• Elizabeth A Gill, DPT
• Melissa Gillogly, RBT
• Mary Glass, MD
• Kimberly Gonzales Zenon
• Kyle Robert Graper, M.D.
• Sarah Gray
• Greater Lafayette Health Services
• Thomas Greffly, ATC LAT
• Victoria Gregory, DC, MS

• All providers in Crawfordsville, IN
• Durable Medical Equipment & Medical Supplies in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.