Gary Earle Radish, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD504 Issued in TN

Practice address

2699 Townsend CT
Clarksville, TN 37043-6487

Phone

(931) 647-8417

Fax

(931) 648-4435

NPI assigned

Feb 2, 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

Other identifiers 2

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.

• Lynn & York, Optometrists, PC

  • Optometrist
  • Clarksville, TN
  • NPI 1346449733
  NPD (past)

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424304000000",
    "number": "1881666030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2699 TOWNSEND CT",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370436487",
            "telephone_number": "931-647-8417",
            "fax_number": "931-648-4435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2699 TOWNSEND CT",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370436487",
            "telephone_number": "931-647-8417",
            "fax_number": "931-648-4435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADISH",
        "first_name": "GARY",
        "middle_name": "EARLE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2015-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "OD504",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3599833",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q009062",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Qusayy M. Godbolt
• Ashley Nicole Rabuck, OTD, OTR/L
• Chelsie Raby
• Daniel Rachlin, PHD
• Radiology Associates
• Rainbow Enterprise PLC
• Rainbow Kids Clinic
• Ryan Rainey, SLP-CCC
• Amanda Gail Rains, M.S., CCC-SLP
• Raintree Counseling PLLC

• Optometrist in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.