Individual provider Active NPI

Gary William Murrell, O.D.

  • Optometrist
  • Anniston, AL
National Provider Identifier
1619060522
Registry record updated Sep 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
S514TA101 Issued in AL
Practice address
425 E 10TH St
Suite C
Anniston, AL 36207-4787
Phone
(256) 236-7516
Fax
(256) 237-6730
NPI assigned
Oct 2, 2006
Last updated
Sep 30, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X S514TA101 AL Primary

Addresses

Primary practice location

425 E 10TH St
Suite C
Anniston, AL 36207-4787

Mailing address

425 E 10TH St
Suite C
Anniston, AL 36207-4787
Phone (256) 236-7516

Other identifiers 1

IdentifierTypeStateIssuer
000059777MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090211000687 AL Practitioner - Optometry 7416012265 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S514TA101ALMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Eyecare Associates, PC Optometrist CurrentSince Jul 28, 1995 Accepting new patients

Locations

425 E 10th St
Ste C
Anniston, AL 36207
Phone (256) 236-7516

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285804800000",
    "number": "1619060522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 E 10TH ST",
            "address_2": "SUITE C",
            "city": "ANNISTON",
            "state": "AL",
            "postal_code": "362074787",
            "telephone_number": "256-236-7516",
            "fax_number": "256-237-6730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 E 10TH ST",
            "address_2": "SUITE C",
            "city": "ANNISTON",
            "state": "AL",
            "postal_code": "362074787",
            "telephone_number": "256-236-7516",
            "fax_number": "256-237-6730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURRELL",
        "first_name": "GARY",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2010-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S514TA101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000059777",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anniston, AL

Sources for this page

Verify at the official NPI Registry.