Individual provider Active NPI

Gary C Duey, O.D.

  • Optometrist
  • Marietta, GA
National Provider Identifier
1669470480
Registry record updated Oct 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT001420 Issued in GA
Practice address
3405 Dallas Hwy SW
Suite 405
Marietta, GA 30064-6426
Phone
(770) 420-9877
Fax
(770) 420-9898
NPI assigned
Jul 14, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT001420 GA Primary

Addresses

Primary practice location

3405 Dallas Hwy SW
Suite 405
Marietta, GA 30064-6426

Mailing address

3405 Dallas Hwy SW
Suite 405
Marietta, GA 30064-6426
Phone (770) 420-9877

Other identifiers 2

IdentifierTypeStateIssuer
52576494OtherGABLUE CROSS/BLUE SHIELD
760646583AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20060523000027 GA Practitioner - Optometry 9931110301 Practice locations: Marietta, GA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Zeena Optical LLC Optometrist PastSince Apr 3, 2022 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": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383091200000",
    "number": "1669470480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3405 DALLAS HWY SW",
            "address_2": "SUITE 405",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300646426",
            "telephone_number": "770-420-9877",
            "fax_number": "770-420-9898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3405 DALLAS HWY SW",
            "address_2": "SUITE 405",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300646426",
            "telephone_number": "770-420-9877",
            "fax_number": "770-420-9898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUEY",
        "first_name": "GARY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-14",
        "last_updated": "2013-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT001420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "52576494",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "760646583A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.