JONATHAN ALAN GUDEMAN (NPI# 1760477228) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760477228 |
| Entity Type | Individual |
| Full Name | JONATHAN ALAN GUDEMAN |
| Credential | O.D. |
| Practice Address |
101 W 4th St Salem VA 24153-3638 |
| Practice Telephone | 5403871183 |
| Mailing Telephone | 5403871183 |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2011-09-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 0618000618 | VA | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | ADMINISTAR FEDERAL | 4715110001 | 01 |
| VA | PALMETTO GBA | 410049826 | 01 |
| VA | ANTHEM | 461361 | 01 |
| VA | 9237216 | 05 |
| Street Address |
101 W 4TH ST |
| City | SALEM |
| State | VA |
| Zip Code | 24153-3638 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588224026 | Katelyn Palmer | Optometrist | 101 W 4th St, Salem, VA 24153-3638 | 2019-06-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669001228 | Paul Mcguire | Student in an Organized Health Care Education/Training Program | 1906 Braeburn Drive Psychiatry Gme, Salem, VA 24153 | 2020-04-06 |
| 1386114965 | Dynamic Medical LLC | Clinical Medical Laboratory | 1201 Texas Street, Salem, VA 24153 | 2018-11-27 |
| 1134607898 | Renew Psychiatry Services | Psychiatry & Neurology | 177 Electric Rd, Salem, VA 24153 | 2018-08-03 |
| 1508304015 | Samantha Getz | Assisted Living Facility | 3706 Knollridge Rd., Salem, VA 24153 | 2017-02-03 |
| 1518409762 | Melissa Ward | Case Manager/Care Coordinator | 1380 Southside Dr, Suite 100, Salem, VA 24153 | 2016-11-04 |
| 1154729051 | Allison Marie Parry | Physician Assistant | 1336 W Main St., Salem, VA 24153 | 2014-12-09 |
| 1598199457 | Stacy Stanley | Occupational Therapy Assistant | 4812 Moore Rd, Salem, VA 24153 | 2013-08-28 |
| 1366888034 | Dolores Hager | Speech-Language Pathologist | 1851 Harrogate Dr, Salem, VA 24153 | 2013-05-21 |
| 1073850764 | Joel Aaron Nickerson | Specialist/Technologist | 400 Spartan Dr., Salem High School, Salem, VA 24153 | 2013-01-15 |
| 1023387271 | National Diabetic Medical Supply, LLC | Durable Medical Equipment & Medical Supplies | 2153 Apperson Drive, Salem, VA 24153 | 2011-12-16 |
| Find all providers in zip 24153 | ||||
| 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 |
|---|---|---|---|---|
| 1225638463 | Troy Sanfilippo | Optometrist | 286 Laurelwood Dr, Salem, CT 06420-3937 | 2020-10-27 |
| 1275024135 | Rhode Island Optometrics, LLC | Optometrist | 42 Samoset Dr, Salem, NH 03079 | 2018-05-25 |
| 1003367145 | Melda Nil Esendal | Optometrist | 116r Highland Avenue, Salem, MA 01970 | 2016-10-24 |
| 1487008603 | Douglas Robert Clark | Optometrist | 446 N State Road 198, Salem, UT 84653 | 2016-04-14 |
| 1073948311 | Orbal Mariam Anwari | Optometrist | 305 Liberty St Ne, Salem, OR 97301-3519 | 2013-09-05 |
| 1497195648 | Dr Zhu Eye Associates | Optometrist | 326 N Broadway, Vision Center Inside Walmart, Salem, NH 03079-2122 | 2013-07-02 |
| 1538429816 | Eyeglass Factory | Optometrist | 1885 25th St Se, Salem, OR 97302-1105 | 2012-05-21 |
| 1851607014 | Kendall Loraine Harer Mault | Optometrist | 116r Highland Ave Fl 2, Salem, MA 01970-2723 | 2010-08-26 |
| 1871738898 | Julie A. Mackall Od LLC | Optometrist | 2400 Southeast Blvd Ste A, Salem, OH 44460-3482 | 2008-12-04 |
| 1598915811 | Elizabeth Wolff | Optometrist | 400 N Broadway Ave, Salem, IL 62881-1514 | 2008-09-23 |
| Find all providers in SALEM | ||||
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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.