Gino Terry Carmolli, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1410 Issued in AZ

Practice address

13125 N la Montana Dr
Suite #1
Fountain Hills, AZ 85268-3781

Phone

(480) 816-0102

Fax

(480) 816-0102

NPI assigned

Dec 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• John H McDougall OD Arizona PC

  • Optometrist
  • Fountain Hills, AZ
  • NPI 1851882179
  NPD (past)
• Tom Sowash OD & Associates PC

  • Optometrist
  • Chandler, AZ
  • NPI 1174627202
  NPD (past)
• Visionworks Inc

  • Eyewear Supplier
  • Gilbert, AZ
  • NPI 1306099643
  NPD (past)

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437955200000",
    "number": "1841352002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15560 N FRANK LLOYD WRIGHT BLVD B2",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852602020",
            "telephone_number": "480-661-8733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13125 N LA MONTANA DR",
            "address_2": "SUITE #1",
            "city": "FOUNTAIN HILLS",
            "state": "AZ",
            "postal_code": "852683781",
            "telephone_number": "480-816-0102",
            "fax_number": "480-816-0102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARMOLLI",
        "first_name": "GINO",
        "middle_name": "TERRY",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2015-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "1410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Capella Eyecare
• Cardinal Home Care, LLC
• Care Imaging and Diagnosis Limited
• Adasiah Carlson
• Kristyn Carlson
• Teresa Rae Carnell
• Kathleen A Carroll, MS,CCC-SLP
• Loren K Carroll, PT
• Brielle Elise Casas, SLP
• Martin M Case Jr., BC-HIS ,ACA,COHC

• Optometrist in Fountain Hills, AZ
• Providers in Fountain Hills, AZ by specialty
• Optometrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2015; 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.