Individual provider Active NPI

J Campbell Gaunt, OD

  • Optometrist
  • Englewood, FL
National Provider Identifier
1992816110
Registry record updated Feb 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC1220 Issued in FL
Practice address
1800 S McCall Rd
Englewood, FL 34223-4958
Phone
(941) 474-2020
Fax
(941) 473-4142
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC1220 FL Primary

Addresses

Primary practice location

1800 S McCall Rd
Englewood, FL 34223-4958

Mailing address

1360 E Venice Ave
Venice, FL 34285-9066
Phone (941) 488-2020

Other identifiers 2

IdentifierTypeStateIssuer
19468OtherFLBCBS
620103200MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jfezza@useye.intellechartdirect.net

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

State licenses

LicenseStateTypeSpecialty
1220FLMDHand Occupational Therapist

Interoperability endpoints

  • Direct secure messaging: jfezza@useye.intellechartdirect.net

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645660800000",
    "number": "1992816110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 E VENICE AVE",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342859066",
            "telephone_number": "941-488-2020",
            "fax_number": "941-484-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 S MCCALL RD",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342234958",
            "telephone_number": "941-474-2020",
            "fax_number": "941-473-4142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUNT",
        "first_name": "J",
        "middle_name": "CAMPBELL",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC1220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "19468",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620103200",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jfezza@useye.intellechartdirect.net",
            "affiliation": "N",
            "address_1": "1800 S McCall Rd",
            "city": "Englewood",
            "state": "FL",
            "country_code": "US",
            "postal_code": "342234958",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Englewood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2022; 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.