Individual provider Active NPI

Julia H Gannon, OD

  • Optometrist
  • Birmingham, AL
National Provider Identifier
1760478226
Registry record updated Oct 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
S708TA316 Issued in AL
Practice address
1201 11TH Ave S
Suite 501
Birmingham, AL 35205-3423
Phone
(205) 930-0930
Fax
(205) 930-9050
NPI assigned
Sep 21, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X S708TA316 AL Primary

Addresses

Primary practice location

1201 11TH Ave S
Suite 501
Birmingham, AL 35205-3423

Mailing address

1201 11TH Ave S
Suite 501
Birmingham, AL 35205-3423
Phone (205) 930-0930

Other identifiers 2

IdentifierTypeStateIssuer
528500580MedicaidAL
51502838OtherALBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20100921001168 AL Practitioner - Optometry 1355466848 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Partners PCGroup PAC ID 8123016334, 31 clinicians

Practice addresses (Care Compare)

262 Mitylene Park Dr
Montgomery, AL 36117-3548
Phone (334) 260-8511

Merit-based Incentive Payment System (MIPS)

Final score
84.59 of 100Reported as group
Quality
87.13
Promoting interoperability
95
Improvement activities
40
Cost
65.66

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Alabama Eye & Cataract Center PC CurrentSince May 17, 2017 Accepting new patients
Eye Partners PC CurrentSince Aug 1, 2020 Accepting new patients
Eye Partners PC Optometrist CurrentSince Aug 1, 2020 Accepting new patients
University of Alabama Health Services Foundation, PC. Past Accepting new patients

Locations

1201 11th Ave S
#501
Birmingham, AL 35205
Phone (205) 930-0930

1201 11th Ave S
Ste 501
Birmingham, AL 35205
Phone (205) 930-0930

2800 Ross Clark Cir
Dothan, AL 36301
Phone (334) 793-3411

262 Mitylene Park Dr
Montgomery, AL 36117
Phone (334) 260-8511

10200 US Highway 231
Wetumpka, AL 36092
Phone (334) 567-7722

Interoperability endpoints

  • Direct secure messaging: julia.gannon.p1@direct.ecs.nextgenshare.com

Organizations & group practices 4

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": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508284800000",
    "number": "1760478226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 11TH AVE S",
            "address_2": "SUITE 501",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352053423",
            "telephone_number": "205-930-0930",
            "fax_number": "205-930-9050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 11TH AVE S",
            "address_2": "SUITE 501",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352053423",
            "telephone_number": "205-930-0930",
            "fax_number": "205-930-9050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANNON",
        "first_name": "JULIA",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-21",
        "last_updated": "2017-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S708TA316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "528500580",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51502838",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.