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NPI 1174476162ActiveOrganization· Optometrist· Great Falls, MT
Optometrist in Great Falls, Montana, registered in NPPES in February 2026. The authorized official on file is Samuel Jacob Gouchenour, OD, Optometrist. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1174476162 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 18, 2026 |
| Last updated in NPPES | Aug 20, 2026 |
| Certified by provider | Aug 20, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Optometrist Primary | 152W00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MT) |
|---|
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