Active NPI
Gary Michael Nadolsky, O.D.
- Optometrist
- Mountain Home, TN
National Provider Identifier
1770713240
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OD0000002890
- Practice address
- Corner of Lamont and Sydney Streets Building 200
Mountain Home, TN 37684 - Phone
- (423) 926-1171
- NPI assigned
- Jul 19, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OD0000002890 | TN | Primary |
Addresses
Primary practice location
Corner of Lamont and Sydney Streets Building 200
Mountain Home, TN 37684
Mailing address
Corner of Lamont and Sydney Streets Building 200
Mountain Home, TN 37684
Phone (423) 926-1171
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OD0000002890 | TN | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569974400000",
"number": "1770713240",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "CORNER OF LAMONT AND SYDNEY STREETS BUILDING 200",
"city": "MOUNTAIN HOME",
"state": "TN",
"postal_code": "37684",
"telephone_number": "423-926-1171"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CORNER OF LAMONT AND SYDNEY STREETS BUILDING 200",
"city": "MOUNTAIN HOME",
"state": "TN",
"postal_code": "37684",
"telephone_number": "423-926-1171"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NADOLSKY",
"first_name": "GARY",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-07-19",
"last_updated": "2019-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TN",
"license": "OD0000002890",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mountain Home, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.