Individual provider Active NPI

Gary G Carothers, M.D.

  • Ophthalmology Physician
  • Cincinnati, OH
National Provider Identifier
1679575948
Registry record updated Jan 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
35.028347 Issued in OH
Practice address
7730 Montgomery Rd Ste 120
Cincinnati, OH 45236-4284
Phone
(513) 791-5999
Fax
(513) 791-4567
NPI assigned
Jun 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 35.028347 OH Primary

Addresses

Primary practice location

7730 Montgomery Rd Ste 120
Cincinnati, OH 45236-4284

Mailing address

PO Box 631662
Cincinnati, OH 45263-1662
Phone (859) 581-7120

Other identifiers 3

IdentifierTypeStateIssuer
0213183MedicaidOH
180021895OtherMEDICARE RAILROAD
64010390MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040528001118 OH Practitioner - Ophthalmology 1355237546

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35.028347OHMDOphthalmology Physician

NPI Registry JSON

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548201600000",
    "number": "1679575948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 631662",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452631662",
            "telephone_number": "859-581-7120",
            "fax_number": "859-581-7207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7730 MONTGOMERY RD STE 120",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452364284",
            "telephone_number": "513-791-5999",
            "fax_number": "513-791-4567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAROTHERS",
        "first_name": "GARY",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2019-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OH",
            "license": "35.028347",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0213183",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "180021895",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64010390",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.