Active NPI
Gertrude Elsie Roth, OD
- Optometrist
- Greensboro, NC
National Provider Identifier
1568675759
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1138
- Practice address
- 2154 A Lawndale Drive
Greensboro, NC 27408-7102 - Phone
- (336) 275-1254
- NPI assigned
- May 7, 2007
- Sex
- Female
- Sole proprietor
- No
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 | 1138 | NC | Primary |
Addresses
Primary practice location
2154 A Lawndale Drive
Greensboro, NC 27408-7102
Mailing address
2154 A Lawndale Drive
Greensboro, NC 27408-7102
Phone (336) 275-1254
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1138 | NC | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1568675759",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2154 A LAWNDALE DRIVE",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274087102",
"telephone_number": "336-275-1254"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2154 A LAWNDALE DRIVE",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274087102",
"telephone_number": "336-275-1254"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROTH",
"first_name": "GERTRUDE",
"middle_name": "ELSIE",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NC",
"license": "1138",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greensboro, NC
Sources for this page
- 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.