David a Gladwell OD Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

0601000565 Issued in VA

Legal business name

DAVID A GLADWELL OD INC

Practice address

412 N Bridge St
Bedford, VA 24523-0238

Phone

(540) 586-9575

Fax

(540) 586-0129

NPI assigned

Apr 5, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Cynthia Porter Mayhew

Title

Secretary Receptionist

Phone

(540) 586-9575

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204761600000",
    "number": "1922060979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 N BRIDGE ST",
            "city": "BEDFORD",
            "state": "VA",
            "postal_code": "245230238",
            "telephone_number": "540-586-9575",
            "fax_number": "540-586-0129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 N BRIDGE ST",
            "city": "BEDFORD",
            "state": "VA",
            "postal_code": "245230238",
            "telephone_number": "540-586-9575",
            "fax_number": "540-586-0129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID A GLADWELL OD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-05",
        "last_updated": "2008-03-06",
        "status": "A",
        "authorized_official_last_name": "MAYHEW",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "PORTER",
        "authorized_official_title_or_position": "SECRETARY RECEPTIONIST",
        "authorized_official_telephone_number": "540-586-9575",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0601000565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "066991",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADMINASTAR FEDERAL DMERC",
            "identifier": "0497490001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Bedford, VA
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.