Gillette Optometric Clinic PC
NPI 1891850707ActiveOrganization· Optometrist, Corneal and Contact Management· Gillette, WY
Optometrist, Corneal and Contact Management in Gillette, Wyoming, registered in NPPES in December 2006. The authorized official on file is Roger L. Jordan, O.D., President. Enrolled in Medicare as dme supplier - physician - optometrist and part b supplier - clinic/group practice.
Overview
| NPI | 1891850707 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 22, 2006 |
| Last updated in NPPES | Apr 13, 2010 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Optometrist, Corneal and Contact Management Primary | 152WC0802X | 142-T | WY |
| Optometrist | 152W00000X | 93-T | WY |
| Optometrist, Corneal and Contact Management | 152WC0802X | 288-T | WY |
| Optometrist, Vision Therapy | 152WV0400X | 263-T | WY |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Physician - Optometrist (WY); Part B Supplier - Clinic/Group Practice (WY) |
|---|
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