Active NPI
John Gadsby Birdsall III, OPHTHALMIC DISPENSER
- Optician
- Norwich, NY
National Provider Identifier
1578613006
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 5008
- Practice address
- 5811 County RT. 32
Norwich, NY 13815 - Phone
- (607) 336-2020
- Fax
- (607) 336-1003
- NPI assigned
- Jan 10, 2007
- Last updated
- Jul 9, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Optician | 156FX1800X | 5008 | NY | Primary |
Addresses
Primary practice location
5811 County RT. 32
Norwich, NY 13815
Mailing address
10 Vine St.
PO Box 28
Gilbertsville, NY 13776
Phone (607) 783-2222
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5008 | NY | MD | Optician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hansen Vision Group LLC | Past | Accepting new patients | |
| Chenango Vision Center, Inc. | Optician | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Durable Medical Equipment & Medical Supplies
- Norwich, NY
- NPI 1689882151
Optician
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1578613006",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 VINE ST.",
"address_2": "PO BOX 28",
"city": "GILBERTSVILLE",
"state": "NY",
"postal_code": "13776",
"telephone_number": "607-783-2222",
"fax_number": "607-336-1003"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5811 COUNTY RT. 32",
"city": "NORWICH",
"state": "NY",
"postal_code": "13815",
"telephone_number": "607-336-2020",
"fax_number": "607-336-1003"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BIRDSALL",
"first_name": "JOHN",
"middle_name": "GADSBY",
"name_prefix": "Mr.",
"name_suffix": "III",
"credential": "OPHTHALMIC DISPENSER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-10",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "NY",
"license": "5008",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norwich, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.