NPIMap

Organization Active NPI

A. L. Harrell,III, O.D., P.a.

  • Optometrist
  • Wellington, FL
National Provider Identifier
1083914808
Registry record updated May 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OP 1746 Issued in FL
Legal business name
A. L. HARRELL,III, O.D., P.A.
Practice address
11924 W Forest Hill Blvd
31
Wellington, FL 33414-6256
Phone
(561) 798-8282
Fax
(561) 798-2840
NPI assigned
Oct 26, 2010
Last updated
May 10, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2011

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

Authorized official

Name
Dr. Albert L. Harrell III, O.D.NPI 1689711194
Title
President
Phone
(561) 798-8282

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OP 1746 FL Primary

Addresses

Primary practice location

11924 W Forest Hill Blvd
31
Wellington, FL 33414-6256

Mailing address

11924 W Forest Hill Blvd
31
Wellington, FL 33414-6256
Phone (561) 798-8282

Other identifiers 2

IdentifierTypeStateIssuer
0776020002OtherFLDMERC
078294701MedicaidFL

National Provider Directory

National Provider Directory

Locations

11924 Forest Hill Blvd
#31W
Wellington, FL 33414
Phone (561) 798-8282

11924 Forest Hill Blvd
Ste 31
Wellington, FL 33414
Phone (561) 798-8282

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1288051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304985600000",
    "number": "1083914808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11924 W FOREST HILL BLVD",
            "address_2": "31",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334146256",
            "telephone_number": "561-798-8282",
            "fax_number": "561-798-2840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11924 W FOREST HILL BLVD",
            "address_2": "31",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334146256",
            "telephone_number": "561-798-8282",
            "fax_number": "561-798-2840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A. L. HARRELL,III, O.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-26",
        "last_updated": "2011-05-10",
        "status": "A",
        "authorized_official_last_name": "HARRELL",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-798-8282",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OP 1746",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "0776020002",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "078294701",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2011; 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.