Individual provider Active NPI

Thomas Gober, OD

  • Optometrist
  • Clarksville, IN
National Provider Identifier
1619974722
Registry record updated May 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18002107A Issued in IN
Practice address
325 E Lewis and Clark Pkwy Ste 200
Clarksville, IN 47129-1725
Phone
(812) 288-2029
Fax
(502) 736-4490
NPI assigned
Jul 5, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1530DT KY
Optometrist 152W00000X 18002107A IN Primary

Addresses

Primary practice location

325 E Lewis and Clark Pkwy Ste 200
Clarksville, IN 47129-1725

Mailing address

PO Box 207170
Dallas, TX 75320-7170
Phone (636) 200-4393

Other identifiers 1

IdentifierTypeStateIssuer
100100740MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, KY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20041202000612 IN Practitioner - Optometry 3971569880 Reassigns benefits to 1 organization
I20081224000306 KY Practitioner - Optometry 3971569880 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clarkson Optometry Midwest Inc 78 clinicians

Practice addresses (Care Compare)

325 E Lewis and Clark Pkwy
Suite 200
Clarksville, IN 47129-1725
Phone (818) 288-2029

43 Industrial Pkwy
Calvert City, KY 42029-8416
Phone (270) 395-8331

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18002107AINMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Clarkson Optometry Midwest Inc Optometrist Current Accepting new patients
Cincinnati Eye Care Team LLC Optometrist Past Accepting new patients

Locations

43 Industrial Pkwy
Calvert City, KY 42029
Phone (270) 395-8331

3978 Alexandria Pike
Cold Spring, KY 41076
Phone (859) 441-8500

10639 Dixie Hwy
Louisville, KY 40272
Phone (502) 231-2020

6828 Bardstown Rd
Louisville, KY 40291
Phone (502) 231-2020

Interoperability endpoints

  • Direct secure messaging: thomasgober@direct.eyecare-partners.com

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620345600000",
    "number": "1619974722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 207170",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753207170",
            "telephone_number": "636-200-4393",
            "fax_number": "636-527-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 E LEWIS AND CLARK PKWY STE 200",
            "city": "CLARKSVILLE",
            "state": "IN",
            "postal_code": "471291725",
            "telephone_number": "812-288-2029",
            "fax_number": "502-736-4490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOBER",
        "first_name": "THOMAS",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2021-05-07",
        "certification_date": "2021-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1530DT",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002107A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100100740",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, IN

Sources for this page

Verify at the official NPI Registry.