Individual provider Active NPI

James Edward Grau, O.D.

  • Optometrist
  • Abingdon, VA
National Provider Identifier
1992806566
Registry record updated Apr 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618000167 Issued in VA
Practice address
699 McBroom St NW
Suite a
Abingdon, VA 24210-2511
Phone
(276) 628-1143
Fax
(276) 628-9522
NPI assigned
Sep 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618000167 VA Primary

Addresses

Primary practice location

699 McBroom St NW
Suite a
Abingdon, VA 24210-2511

Mailing address

699 McBroom St NW
Suite a
Abingdon, VA 24210-2511
Phone (276) 628-1143

Other identifiers 1

IdentifierTypeStateIssuer
009205136MedicaidVA

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

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302825600000",
    "number": "1992806566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "699 MCBROOM ST NW",
            "address_2": "SUITE A",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242102511",
            "telephone_number": "276-628-1143",
            "fax_number": "276-628-9522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "699 MCBROOM ST NW",
            "address_2": "SUITE A",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242102511",
            "telephone_number": "276-628-1143",
            "fax_number": "276-628-9522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAU",
        "first_name": "JAMES",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2011-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618000167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009205136",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Abingdon, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2011; 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.