Individual provider Active NPI

Jerry Curtis Elder, OPTICIAN PRESIDENT O

  • Optician
  • Lynchburg, VA
National Provider Identifier
1629121983
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
433 Issued in VA
Practice address
2124 Langhorne Road
Lynchburg, VA 24501-1424
Phone
(434) 845-6120
Fax
(434) 845-6120
NPI assigned
Jan 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 433 VA Primary

Addresses

Primary practice location

2124 Langhorne Road
Lynchburg, VA 24501-1424

Mailing address

2124 Langhorne Road
Lynchburg, VA 24501-1424
Phone (434) 845-6120

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

LicenseStateTypeSpecialty
433VAMDOptician

Practice roles

OrganizationSpecialtyStatusNew patients
Cooper & Elder Optical Inc. Optician Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629121983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2124 LANGHORNE ROAD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245011424",
            "telephone_number": "434-845-6120",
            "fax_number": "434-845-6120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2124 LANGHORNE ROAD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245011424",
            "telephone_number": "434-845-6120",
            "fax_number": "434-845-6120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDER",
        "first_name": "JERRY",
        "middle_name": "CURTIS",
        "name_prefix": "Mr.",
        "credential": "OPTICIAN PRESIDENT O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "VA",
            "license": "433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynchburg, VA

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.

Verify at the official NPI Registry.