NPIMap

Organization Active NPI

Gary Lee Dietterick

Doing business as Palmer Family Eye Care

  • Optometrist
  • Easton, PA
National Provider Identifier
1700803897
Registry record updated Oct 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG000606 Issued in PA
Legal business name
GARY LEE DIETTERICK
Doing business as
Palmer Family Eye Care
Practice address
21 Corporate Dr
Easton, PA 18045-2664
Phone
(610) 258-2442
Fax
(610) 258-7961
NPI assigned
Jul 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2014

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

Authorized official

Name
Dr. Gary L Dietterick, ODNPI 1407836851
Title
Dr/Owner
Phone
(610) 258-2442

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OEG000606 PA Primary

Addresses

Primary practice location

21 Corporate Dr
Easton, PA 18045-2664

Mailing address

21 Corporate Dr
Easton, PA 18045-2664
Phone (610) 258-2442

Other identifiers 5

IdentifierTypeStateIssuer
DD4313OtherPAPALMETTO GBA RAILROAD MED
02669200OtherPACAPITAL BLUE CROSS
3803518OtherPAAETNA
624066OtherPAHIGHMARK BLUE SHIELD
02669200OtherPAKEYSTONE

Other names 1

  • Palmer Family Eye Care Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412899200000",
    "number": "1700803897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 CORPORATE DR",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180452664",
            "telephone_number": "610-258-2442",
            "fax_number": "610-258-7961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 CORPORATE DR",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180452664",
            "telephone_number": "610-258-2442",
            "fax_number": "610-258-7961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY LEE DIETTERICK",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2014-10-10",
        "status": "A",
        "authorized_official_last_name": "DIETTERICK",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DR/OWNER",
        "authorized_official_telephone_number": "610-258-2442",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA RAILROAD MED",
            "identifier": "DD4313",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "02669200",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3803518",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "624066",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE",
            "identifier": "02669200",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Palmer Family Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Easton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.