Individual provider Active NPI

Samuel Jacob Gouchenour Jr., O.D.

  • Optometrist
  • Great Falls, MT
National Provider Identifier
1700739901
Registry record updated Aug 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT-OPT-LIC-5669 Issued in MT
Practice address
3226 10TH Ave S
Great Falls, MT 59405-3449
Phone
(406) 289-0833
NPI assigned
Feb 17, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OPT-OPT-LIC-5669 MT Primary

Addresses

Primary practice location

3226 10TH Ave S
Great Falls, MT 59405-3449

Mailing address

3226 10TH Ave S
Great Falls, MT 59405-3449
Phone (406) 289-0833

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT-OPT-LIC-5669MTMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Go and See PC Optometrist Current 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": "1771286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1700739901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3226 10TH AVE S",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594053449",
            "telephone_number": "406-289-0833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3226 10TH AVE S",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594053449",
            "telephone_number": "406-289-0833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOUCHENOUR",
        "first_name": "SAMUEL",
        "middle_name": "JACOB",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-02-17",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MT",
            "license": "OPT-OPT-LIC-5669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Falls, MT

Sources for this page

Verify at the official NPI Registry.