Active NPI
J Campbell Gaunt, OD
- Optometrist
- Englewood, FL
National Provider Identifier
1992816110
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPC1220
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 19468 | Other | FL | BCBS |
| 620103200 | Medicaid | FL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 1220 | FL | MD | Hand Occupational Therapist |
Interoperability endpoints
- 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.