NPIMap

Individual provider Active NPI

Edward James Guggemos, O.D.

  • Optometrist
  • Tampa, FL
National Provider Identifier
1629132774
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC2777 Issued in FL
Practice address
15909 Farringham Dr
Tampa, FL 33647-1109
Phone
(813) 971-6193
NPI assigned
Dec 21, 2006
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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0601001988 VA
Optometrist 152W00000X OD00004116 WA
Optometrist 152W00000X OPC2777 FL Primary

Addresses

Primary practice location

15909 Farringham Dr
Tampa, FL 33647-1109

Mailing address

15909 Farringham Dr
Tampa, FL 33647-1109
Phone (813) 971-6193

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

LicenseStateTypeSpecialty
OPC2777FLMDOptometrist
0601001988VAMDOptometrist
OD00004116WAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629132774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15909 FARRINGHAM DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336471109",
            "telephone_number": "813-971-6193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15909 FARRINGHAM DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336471109",
            "telephone_number": "813-971-6193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUGGEMOS",
        "first_name": "EDWARD",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0601001988",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00004116",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC2777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

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.