Individual provider Active NPI

Gregory Nixon, O.D.

  • Optometrist
  • Columbus, OH
National Provider Identifier
1972629467
Registry record updated Dec 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4773-T1577 Issued in OH
Practice address
1664 Neil Ave
Columbus, OH 43201-2333
Phone
(614) 292-2020
Fax
(614) 247-4543
NPI assigned
Mar 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4773-T1577 OH Primary

Addresses

Primary practice location

1664 Neil Ave
Columbus, OH 43201-2333

Mailing address

1664 Neil Ave
Columbus, OH 43201-2333
Phone (614) 292-2020

Other practice location 1

1800 Zollinger Rd Ste 1500
Upper Arlington, OH 43221-2849
Phone (614) 366-3937

Other identifiers 1

IdentifierTypeStateIssuer
2373873MedicaidOH

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20041118000005 OH Practitioner - Optometry 5799749867 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohio State UniversityGroup PAC ID 6103866207, 42 clinicians

Practice addresses (Care Compare)

1664 Neil Ave
Columbus, OH 43201-2333
Phone (614) 292-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4773OHMDClinical Psychologist
4773-T1577OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio State University Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1972629467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1664 NEIL AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432012333",
            "telephone_number": "614-292-2020",
            "fax_number": "614-247-4543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1664 NEIL AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432012333",
            "telephone_number": "614-292-2020",
            "fax_number": "614-247-4543"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 Zollinger Rd Ste 1500",
            "address_purpose": "LOCATION",
            "city": "Upper Arlington",
            "state": "OH",
            "postal_code": "432212849",
            "country_code": "US",
            "telephone_number": "614-366-3937",
            "fax_number": "614-366-3865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIXON",
        "first_name": "GREGORY",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-22",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4773-T1577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2373873",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.