Individual provider Active NPI

Johneen Gilich, OD

  • Optometrist
  • Picayune, MS
National Provider Identifier
1639258411
Registry record updated Oct 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
764 Issued in MS
Practice address
235 Frontage Rd
Picayune, MS 39466-7587
Phone
(228) 861-6989
Fax
(601) 799-4685
NPI assigned
Nov 3, 2006
Last updated
Oct 23, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1428-569T LA
Optometrist 152W00000X 764 MS Primary

Addresses

Primary practice location

235 Frontage Rd
Picayune, MS 39466-7587

Mailing address

2318 Pass Rd Ste 1
Biloxi, MS 39531-4044
Phone (228) 967-7813

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20101130001265 MS Practitioner - Optometry 5395747901 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2318 Pass Rd
Suite 1
Biloxi, MS 39531-4044
Phone (228) 967-7813

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery41

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1428-569TLAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Gilich Enterprises, LLC Optometrist CurrentSince Aug 21, 2010 Accepting new patients
Jason Wonch, O.D. and Associates, a.P.C. Optometrist Past Accepting new patients
Edgewater Eyecare, Inc Optometrist Past Accepting new patients

Locations

2318 Pass Rd
Ste 1
Biloxi, MS 39531
Phone (228) 388-1115

2681 C T Switzer SR Dr
Biloxi, MS 39531
Phone (228) 385-1042

235 Frontage Rd
#B
Picayune, MS 39466
Phone (601) 798-0103

Organizations & group practices 4

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": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603411200000",
    "number": "1639258411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2318 PASS RD STE 1",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395314044",
            "telephone_number": "228-967-7813",
            "fax_number": "228-967-7814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 FRONTAGE RD",
            "city": "PICAYUNE",
            "state": "MS",
            "postal_code": "394667587",
            "telephone_number": "228-861-6989",
            "fax_number": "601-799-4685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILICH",
        "first_name": "JOHNEEN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-03",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "LA",
            "license": "1428-569T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Picayune, MS

Sources for this page

Verify at the official NPI Registry.