Individual provider Active NPI

Thomas Srun, O.D.

  • Optometrist
  • Gaithersburg, MD
National Provider Identifier
1831342393
Registry record updated Oct 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA2124 Issued in MD
Practice address
20414 Sawgrass Dr
Gaithersburg, MD 20886-4597
Phone
(240) 888-0100
NPI assigned
Oct 28, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA2124 MD Primary

Addresses

Primary practice location

20414 Sawgrass Dr
Gaithersburg, MD 20886-4597

Mailing address

20414 Sawgrass Dr
Gaithersburg, MD 20886-4597
Phone (240) 888-0100

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
TA2124MDMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225152000000",
    "number": "1831342393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20414 SAWGRASS DR",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208864597",
            "telephone_number": "240-888-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20414 SAWGRASS DR",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208864597",
            "telephone_number": "240-888-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRUN",
        "first_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-28",
        "last_updated": "2008-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA2124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaithersburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2008; 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.