Brian R Gumm, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1048 Issued in OK

Practice address

2123 W 6TH Ave
Stillwater, OK 74074-4136

Phone

(405) 372-3724

Fax

(405) 743-1042

NPI assigned

Jun 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in OK

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

Specialty

Optometry

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Stillwater Vision Clinic PLLCGroup PAC ID 9436231636, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Stillwater Vision Clinic PLLC

  • Optometrist
  • Stillwater, OK
  • NPI 1912124751
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220572800000",
    "number": "1649211301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2123 W 6TH AVE",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740744136",
            "telephone_number": "405-372-3724",
            "fax_number": "405-743-1042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2123 W 6TH AVE",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740744136",
            "telephone_number": "405-372-3724",
            "fax_number": "405-743-1042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUMM",
        "first_name": "BRIAN",
        "middle_name": "R",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2008-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "1048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410033132",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GOVERNMENT BENEFITS ADMINISTRATORS",
            "identifier": "0210790001",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100766180A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelsey Dawn Grounds, O.D.
• Group Practice Associates, Inc. (Stillwater Internal Medicine)
• Kyla Groves, MD
• William Joesph Groves, LADC
• Jayce Guilfoyle
• Myra Kristine Gustafson
• Erin Renee Gutierrez, RDN
• Hac, Inc. (Homeland Pharmacy #469)
• Michael Wayne Hafner, P.A.
• Victoria Hague

• Optometrist in Stillwater, OK
• Providers in Stillwater, OK by specialty
• Optometrist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.