Individual provider Active NPI

Richard Henry Merrill, OD

  • Optometrist
  • Andalusia, AL
National Provider Identifier
1043312499
Registry record updated Feb 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
S-361-TA-258 Issued in AL
Practice address
406 E Three Notch St
Andalusia, AL 36420-3166
Phone
(334) 222-6632
Fax
(334) 222-9828
NPI assigned
Sep 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X S-361-TA-258 AL Primary

Addresses

Primary practice location

406 E Three Notch St
Andalusia, AL 36420-3166

Mailing address

PO Box 758
Andalusia, AL 36420-1214
Phone (334) 222-6632

Other identifiers 1

IdentifierTypeStateIssuer
0483050001OtherALCIGNA GOVERNMENT SERVICES

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120502000667 AL Practitioner - Optometry 5698882967 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
William M Davidson PC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202947200000",
    "number": "1043312499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 758",
            "city": "ANDALUSIA",
            "state": "AL",
            "postal_code": "364201214",
            "telephone_number": "334-222-6632",
            "fax_number": "334-222-9828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 E THREE NOTCH ST",
            "city": "ANDALUSIA",
            "state": "AL",
            "postal_code": "364203166",
            "telephone_number": "334-222-6632",
            "fax_number": "334-222-9828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRILL",
        "first_name": "RICHARD",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2008-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S-361-TA-258",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA GOVERNMENT SERVICES",
            "identifier": "0483050001",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Andalusia, AL

Sources for this page

Verify at the official NPI Registry.