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Deactivated NPI 1922007251 Deactivated / Inactive NPI Male Practitioner

Dr. Gary Arthur Roach , OD

Optometrist • Mooresville, NC

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Gary Roach has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date July 19, 2005
NPI Deactivation Date March 20, 2006
Total Practice Duration ~1 Years of Practice (2005 – 2006)

Professional Overview & Biography Verified Profile Summary

Dr. Gary Roach, OD was a registered Optometrist practicing in Mooresville, NC. Throughout an active medical career spanning 1 years, Dr. Roach provided care at the practice location at 404 E CENTER AVE until profile deactivation on 2006-03-20.

Practice Location & Contact Primary Location

Practice Address

404 E Center Ave

Mooresville, NC 281152544

Telephone 7046633924
Fax 7046637057
Associated Practice Facility / Clinic
🏢 Gary A. Roach, O.d., P.a. Facility NPI 1922015049

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Mooresville, NC

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 20.8 Yrs
State Avg: 24.4 Yrs
Regional Practice Density
18 Specialists

Practicing in Mooresville, NC (1531 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License NC 863

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
8909775 (NC)
Commercial Insurance / Payer ID Partners
15906 (NC)
Commercial Insurance / Payer ID United Healthcare
2209268 (NC)
Commercial Insurance / Payer ID Bcbs
09775 (NC)
Commercial Insurance / Payer ID Palmetto Dmerc
0236390001 (NC)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
NPI 1033554068

Doctor of Optometry

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
📍
Updated Practice Location November 20, 2014

Registered at 404 E CENTER AVE, MOORESVILLE, NC 281152544 (Tel: 7046633924)

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Updated Business Mailing Address November 20, 2014

Registered at 404 E CENTER AVE, MOORESVILLE, NC 281152544 (Tel: 7046633924)

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Provider Name / Credentials Updated November 20, 2014

Recorded as GARY ROACH, O.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) November 20, 2014

Optometrist (License #863 in NC)

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NPI Profile Reactivated March 23, 2006

Record officially reactivated for active practice on March 23, 2006

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NPI Profile Deactivated March 20, 2006

Record deactivated on March 20, 2006

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Initial NPI Registration & Enumeration July 19, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1922007251
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 19, 2005
Last Update: November 20, 2014
Deactivation Date: March 20, 2006
Sole Proprietor: No

Mailing Address

404 E Center Ave

Mooresville, NC 281152544

Phone: 7046633924

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.