DR. RUSSELL LAMAR GRAY (NPI# 1023678778) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023678778 |
| Entity Type | Individual |
| Full Name | DR. RUSSELL LAMAR GRAY |
| Credential | OD |
| Practice Address |
1926 W State St Boise ID 83702-3957 |
| Mailing Address |
6324 S Ruddsdale Ave Boise ID 83709-1282 |
| Practice Telephone | 2083362020 |
| Mailing Telephone | 2088712936 |
| Enumeration Date | 2019-06-15 |
| Last Update Date | 2019-06-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | ODP-100476 | ID | Eye and Vision Services Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427341015 | Russell Austin Gray | Student in an Organized Health Care Education/Training Program | Dept of Defense Us Air Force 377 Mdg, 2050a Second Street Se Kirtland Afb, Albuquerque, NM 87117-5522 | 2011-05-16 |
| 1831633452 | Russell Gray | Counselor | 139 Renaissance Pkwy Ne, Atlanta, GA 30308-2324 | 2016-12-16 |
| 1144524885 | Russell Clinton Gray | Social Worker | 37 Eagle Way, West Chazy, NY 12992-2562 | 2011-01-10 |
| 1265499065 | Russell Gray | Anesthesiology | 1500 E Duarte Rd, Duarte, CA 91010 | 2006-04-27 |
| Street Address |
1926 W STATE ST |
| City | BOISE |
| State | ID |
| Zip Code | 83702-3957 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548268931 | Todd Anthony Noble | Optometrist | 1926 W State St, Boise, ID 83702-3957 | 2005-07-11 |
| 1386689156 | Amber L Simonson | Optometrist | 1926 W State St, Boise, ID 83702-3957 | 2006-06-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790321966 | Inland Northwest Neuromonitoring Pllc | Psychiatry & Neurology | 950 Bannock Street, Suite 1100, Boise, ID 83702 | 2019-11-22 |
| 1508359084 | Emily Cook | Dietitian, Registered | St. Luke's Rehab Hospital, 600 N Robbins Road, Bosie, ID 83702 | 2018-06-11 |
| 1265925887 | Marla Braendle | Dietitian, Registered | St. Luke's Rehabilitation Hospital, 600 N. Robbins Road, Boise, ID 83702 | 2018-06-08 |
| 1114419678 | Sidrah Khan Psychotherapy PC | Social Worker | 242 N 8th St, Suite 200, Boise, ID 83702 | 2018-05-31 |
| 1508386707 | Emp Idaho Nampa, LLC | General Acute Care Hospital | 350 E Myrtle Street, Suite 100, Boise, ID 83702 | 2017-06-20 |
| 1194264077 | Karen Mangum | Dietitian, Registered | 115 N. Main Street, Suite #203, Boise, ID 83702 | 2017-02-13 |
| 1750828422 | Stephen Pyper | Massage Therapist | 14089 Main St #100, Boise, ID 83702 | 2017-01-19 |
| 1427504398 | The Young Mens Christian Association of Boise City Idaho | Health Educator | 419 N 11th St, Boise, ID 83702 | 2016-08-30 |
| 1942756838 | Brent Hiroshi Sasaki | Pharmacist | 500 West Fort Street (119), Boise, ID 83702 | 2016-08-30 |
| 1578912051 | Marnae Walker | Counselor | 509 S. 14th St, Suite 2, Boise, ID 83702 | 2016-06-06 |
| Find all providers in zip 83702 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215536362 | Daniel & Max, LLC | Optometrist | 1405 N Milwaukee St, Boise, ID 83704-8400 | 2020-10-20 |
| 1326669920 | Clear Eyes Optometric Care, Pllc | Optometrist | 7950 Horseshoe Bend Rd Ste 101, Boise, ID 83714-3809 | 2020-05-05 |
| 1326550096 | Lawrence D Anderson Md Estate | Optometrist | 8955 W Hackamore Dr, Boise, ID 83709 | 2017-11-02 |
| 1407371891 | Emir Hadzic | Optometrist | 13239 W. Fernleaf St., Boise, ID 83713 | 2017-08-07 |
| 1811388796 | Barber Town Eye Care | Optometrist | 3132 S Bown Way, Boise, ID 83706-5400 | 2015-02-12 |
| 1255742532 | Tiffany Risner | Optometrist | 610 S Americana Blvd, Boise, ID 83702-6731 | 2014-05-08 |
| 1154690923 | Gem State Family Eyecare, P.C. | Optometrist | 3815 W State St, Boise, ID 83703-5221 | 2011-12-22 |
| 1750678298 | Wendell Fackrell | Optometrist | 421 N. Cole Rd. Ste 102, Boise, ID 83704 | 2011-07-05 |
| 1972813855 | Dylan L Hatfield | Optometrist | 360 E. Mallard Dr. Ste 110, Hollingshead Eye Center, Boise, ID 83706-3945 | 2010-10-13 |
| 1043521941 | Nessa Livingston | Optometrist | 7960 W Rifleman St Ste 150, Boise, ID 83704-9065 | 2010-06-24 |
| Find all providers in BOISE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.