Active NPI
Gregory John Sophocleus, M.D.
- Ophthalmology Physician
- Baltimore, MD
National Provider Identifier
1871609719
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- M07448
- Practice address
- 6231 N Charles St
Baltimore, MD 21212-1113 - Phone
- (410) 377-2044
- Fax
- (410) 377-8061
- NPI assigned
- Aug 22, 2006
- 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 |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | M07448 | MD | Primary |
Addresses
Primary practice location
6231 N Charles St
Baltimore, MD 21212-1113
Mailing address
1411 Autumn Leaf Rd
Towson, MD 21286-1502
Phone (410) 823-4330
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M07448 | MD | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1871609719",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1411 AUTUMN LEAF RD",
"city": "TOWSON",
"state": "MD",
"postal_code": "212861502",
"telephone_number": "410-823-4330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6231 N CHARLES ST",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212121113",
"telephone_number": "410-377-2044",
"fax_number": "410-377-8061"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOPHOCLEUS",
"first_name": "GREGORY",
"middle_name": "JOHN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "MD",
"license": "M07448",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.