NPIMap

Organization Active NPI

Gerald V Harrell OD PC Professional Corporation Nys

  • Optometrist
  • Plattsburgh, NY
National Provider Identifier
1083782866
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T0026841 Issued in NY
Legal business name
GERALD V HARRELL OD PC PROFESSIONAL CORPORATION NYS
Practice address
70 Court Street
Plattsburgh, NY 12901-2832
Phone
(518) 563-2430
Fax
(518) 563-2474
NPI assigned
Dec 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Gerald Victor Harrell, OD
Title
President Optometrist
Phone
(518) 563-2430

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X T0026841 NY Primary

Addresses

Primary practice location

70 Court Street
Plattsburgh, NY 12901-2832

Mailing address

70 Court Street
Plattsburgh, NY 12901-2832
Phone (518) 563-2430

Other identifiers 1

IdentifierTypeStateIssuer
00623405MedicaidNY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083782866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 COURT STREET",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129012832",
            "telephone_number": "518-563-2430",
            "fax_number": "518-563-2474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 COURT STREET",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129012832",
            "telephone_number": "518-563-2430",
            "fax_number": "518-563-2474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERALD V HARRELL OD PC PROFESSIONAL CORPORATION NYS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HARRELL",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "VICTOR",
        "authorized_official_title_or_position": "PRESIDENT OPTOMETRIST",
        "authorized_official_telephone_number": "518-563-2430",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "T0026841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00623405",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plattsburgh, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.