Active NPI
Rusk Harris, O.D
- Optometrist
- Davie, FL
National Provider Identifier
1013018043
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2847
- Practice address
- 8828 W State Road 84
Davie, FL 33324-4415 - Phone
- (954) 916-8484
- Fax
- (954) 476-2668
- NPI assigned
- Sep 25, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2847 | FL | Primary |
Addresses
Primary practice location
8828 W State Road 84
Davie, FL 33324-4415
Mailing address
8828 W State Road 84
Davie, FL 33324-4415
Phone (954) 916-8484
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 62009230 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1182 | LA | MD | Marriage & Family Therapist |
| 2847 | FL | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| World Vision Centers II Inc | Optometrist | Past | Accepting new patients |
| Lens Spot Inc II | Past | Accepting new patients | |
| Karen Memoli OD PA | Optometrist | Past | Accepting new patients |
| World Vision Center I | Optometrist | Past | Accepting new patients |
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Optometrist
- Coral Springs, FL
- NPI 1720064405
-
- Optometrist
- Hollywood, FL
- NPI 1891771580
-
- Optometrist
- Coral Springs, FL
- NPI 1043540941
-
- Eyewear Supplier
- Hollywood, FL
- NPI 1043487564
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1013018043",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8828 W STATE ROAD 84",
"city": "DAVIE",
"state": "FL",
"postal_code": "333244415",
"telephone_number": "954-916-8484",
"fax_number": "954-476-2668"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8828 W STATE ROAD 84",
"city": "DAVIE",
"state": "FL",
"postal_code": "333244415",
"telephone_number": "954-916-8484",
"fax_number": "954-476-2668"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "RUSK",
"name_prefix": "Dr.",
"credential": "O.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "FL",
"license": "2847",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "62009230",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Davie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.