Individual provider Active NPI

Julia Danielle Harrison, OD

  • Optometrist
  • Bainbridge, GA
National Provider Identifier
1073004602
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT003116 Issued in GA
Practice address
1601 E Shotwell St
Bainbridge, GA 39819-4347
Phone
(229) 246-1600
Fax
(229) 246-1636
NPI assigned
May 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT003116 GA Primary

Addresses

Primary practice location

1601 E Shotwell St
Bainbridge, GA 39819-4347

Mailing address

1601 E Shotwell St
Bainbridge, GA 39819-4347
Phone (229) 246-1600

Other identifiers 1

IdentifierTypeStateIssuer
OPT003116OtherGASTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20180912001861 GA Practitioner - Optometry 0840540886 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bainbridge Eye Care LLCGroup PAC ID 8325491558, 2 clinicians

Practice addresses (Care Compare)

1601 E Shotwell St
Bainbridge, GA 39819-4347
Phone (229) 309-0903

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT003116GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ted a McElroy OD, PC Optometrist CurrentSince Jul 24, 2018 Accepting new patients
Prchal and Prchal, P.C. Optometrist CurrentSince Jul 28, 2025 Accepting new patients
Bainbridge Eye Care, LLC Optometrist CurrentSince Jan 11, 2024 Accepting new patients

Locations

2809 Old Dawson Rd
Albany, GA 31707
Phone (229) 888-3937

1601 E Shotwell St
Bainbridge, GA 39819
Phone (229) 246-1600

26 S Scott St
Camilla, GA 31730
Phone (229) 330-3937

2012 Pineview Ave
Tifton, GA 31794
Phone (229) 382-4765

Interoperability endpoints

  • Direct secure messaging: julia.harrison@direct.revolutionehr.com

Organizations & group practices 3

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": "1526601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1073004602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 E SHOTWELL ST",
            "city": "BAINBRIDGE",
            "state": "GA",
            "postal_code": "398194347",
            "telephone_number": "229-246-1600",
            "fax_number": "229-246-1636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 E SHOTWELL ST",
            "city": "BAINBRIDGE",
            "state": "GA",
            "postal_code": "398194347",
            "telephone_number": "229-246-1600",
            "fax_number": "229-246-1636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "JULIA",
        "middle_name": "DANIELLE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-18",
        "last_updated": "2024-06-05",
        "certification_date": "2023-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "OPT003116",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bainbridge, GA

Sources for this page

Verify at the official NPI Registry.