Justin Case Gillette, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT007009 Issued in OH

Practice address

112 Glover Dr
Mount Orab, OH 45154-8390

Phone

(937) 444-2525

NPI assigned

Mar 30, 2019

Last updated

Oct 21, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Optometry

Education

Ohio State University - College of Optometry, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clarkson Optometry Midwest IncGroup PAC ID 0749504165, 78 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Clarkson Optometry Midwest Inc

  dba Clarkson Eyecare

  • Optometrist
  • Centerville, OH
  • NPI 1073917597
  Medicare reassignment Care Compare group
• Clarkson Optometry Midwest Inc

  dba Clarkson Eyecare

  • Optometrist
  • Alliance, OH
  • NPI 1851971790
  NPD
• Cincinnati Eye Care Team LLC

  dba Cincinnati Eyecare Team

  • Optometrist
  • West Chester, OH
  • NPI 1760412464
  NPD (past)

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

{
    "created_epoch": "1553904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1871054825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 207170",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753207156",
            "telephone_number": "636-200-4393",
            "fax_number": "636-527-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 GLOVER DR",
            "city": "MOUNT ORAB",
            "state": "OH",
            "postal_code": "451548390",
            "telephone_number": "937-444-2525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "740 South Limestone Room C301",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405360293",
            "country_code": "US",
            "telephone_number": "859-323-5867",
            "fax_number": "859-323-1122",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10566 Loveland Madeira Rd",
            "address_purpose": "LOCATION",
            "city": "Loveland",
            "state": "OH",
            "postal_code": "451408962",
            "country_code": "US",
            "telephone_number": "513-683-3791",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILLETTE",
        "first_name": "JUSTIN",
        "middle_name": "CASE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-30",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "2156DT",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "OPT007009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Douglas Anthony Galvin, MHS PT OCS
• Johnathon Garrett
• Steven Garrett
• Rhonda Lynn Gibson, FNP-BC
• Wendy Lynn Gilbert, LPN
• Sidney Gilpin
• Autumn Grant
• Jami A Green, LSW, LCDC III, SWA
• Courtney Grigsby
• Suzanne G. Gunter, DO

• Optometrist in Mount Orab, OH
• Providers in Mount Orab, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.