NPIMap

Organization Active NPI

Gaston Eye Associates

  • Optometrist
  • Dallas, NC
National Provider Identifier
1770565939
Registry record updated Aug 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1048 Issued in NC
Legal business name
GASTON EYE ASSOCIATES
Practice address
820 Lower Dallas Hwy
Dallas, NC 28034-9368
Phone
(704) 922-9808
Fax
(704) 922-8213
NPI assigned
Nov 15, 2005
Last updated
Aug 7, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2008

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

Authorized official

Name
Dr. Randall D Holland, M.D.
Title
Partner
Phone
(704) 922-9808

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 1048 NC Primary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 1826 NC

Addresses

Primary practice location

820 Lower Dallas Hwy
Dallas, NC 28034-9368

Mailing address

820 Lower Dallas Hwy
Dallas, NC 28034-9368
Phone (704) 922-9808

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040920001050 NC Part B Supplier - Clinic/Group Practice 7618945437 Receives reassigned benefits from 11 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Gastonia, NC; Dallas, NC
O20110907001503 NC DME Supplier - Physician - Optometrist 7618945437 Practice locations: Dallas, NC

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Gaston Eye Associates4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

820 Lower Dallas Hwy
Dallas, NC 28034
Phone (704) 922-9808

2325 Aberdeen Blvd
Ste A
Gastonia, NC 28054
Phone (704) 853-3937

Practitioners & affiliated clinicians

Practitioners 11

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": "1132012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218067200000",
    "number": "1770565939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 LOWER DALLAS HWY",
            "city": "DALLAS",
            "state": "NC",
            "postal_code": "280349368",
            "telephone_number": "704-922-9808",
            "fax_number": "704-922-8213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 LOWER DALLAS HWY",
            "city": "DALLAS",
            "state": "NC",
            "postal_code": "280349368",
            "telephone_number": "704-922-9808",
            "fax_number": "704-922-8213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTON EYE ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-15",
        "last_updated": "2008-08-07",
        "status": "A",
        "authorized_official_last_name": "HOLLAND",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "704-922-9808",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1048",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1826",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.