Active NPI
Thomas J Rossi, O.D.
- Optometrist
- Gainesville, GA
National Provider Identifier
1598815490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 915T
- Practice address
- 1276 Jesse Jewell Pkwy SE
Gainesville, GA 30501-3823 - Phone
- (770) 532-7246
- Fax
- (770) 532-2683
- NPI assigned
- Jan 11, 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 915T | GA | Primary |
| Corneal and Contact Management Optometrist | 152WC0802X | 915T | GA | |
| Occupational Vision Optometrist | 152WX0102X | 915T | GA |
Addresses
Primary practice location
1276 Jesse Jewell Pkwy SE
Gainesville, GA 30501-3823
Mailing address
1276 Jesse Jewell Pkwy SE
Gainesville, GA 30501-3823
Phone (770) 532-7246
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 541054 | Other | GA | US HEALTHCARE |
| 300028600A | Other | GA | MEDICAID PAYEE PROVIDER |
| 00339006B | Medicaid | GA | |
| 2230017 | Other | GA | UNITED HEALTHCARE |
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 |
|---|---|---|---|
| 915T | GA | MD | Corneal and Contact Management Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202947200000",
"number": "1598815490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1276 JESSE JEWELL PKWY SE",
"city": "GAINESVILLE",
"state": "GA",
"postal_code": "305013823",
"telephone_number": "770-532-7246",
"fax_number": "770-532-2683"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1276 JESSE JEWELL PKWY SE",
"city": "GAINESVILLE",
"state": "GA",
"postal_code": "305013823",
"telephone_number": "770-532-7246",
"fax_number": "770-532-2683"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSSI",
"first_name": "THOMAS",
"middle_name": "J",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-11",
"last_updated": "2008-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "GA",
"license": "915T",
"primary": true
},
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "GA",
"license": "915T",
"primary": false
},
{
"code": "152WX0102X",
"taxonomy_group": "",
"desc": "Optometrist, Occupational Vision",
"state": "GA",
"license": "915T",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "US HEALTHCARE",
"identifier": "541054",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID PAYEE PROVIDER",
"identifier": "300028600A",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00339006B",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "2230017",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gainesville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.