NPIMap

Organization Active NPI

William C Henson OD PA

Doing business as Blue Ridge Vision

  • Optometrist
  • Boone, NC
National Provider Identifier
1104176882
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
WILLIAM C HENSON OD PA
Doing business as
Blue Ridge Vision
Practice address
1180 Blowing Rock Rd Ste A1
Boone, NC 28607-4600
Phone
(828) 264-2020
NPI assigned
Sep 11, 2012
Last updated
May 20, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2025

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

Authorized official

Name
William C Henson, ODNPI 1225347958
Title
Owner
Phone
(828) 264-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

1180 Blowing Rock Rd Ste A1
Boone, NC 28607-4600

Mailing address

1180 Blowing Rock Rd Ste A1
Boone, NC 28607-4600
Phone (828) 264-2020

Other names 2

  • Blue Ridge Vision Doing business as
  • Daniel J Sullivan OD PA Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121003000591 NC Part B Supplier - Clinic/Group Practice 0749439941 Receives reassigned benefits from 4 practitioners
Practice locations: Boone, NC

National Provider Directory

National Provider Directory

Locations

1180 Blowing Rock Rd
Boone, NC 28607
Phone (828) 264-2020

Practitioners & affiliated clinicians

Practitioners 7

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": "1347321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747699200000",
    "number": "1104176882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 BLOWING ROCK RD STE A1",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286074600",
            "telephone_number": "828-264-2020",
            "fax_number": "828-264-8918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 BLOWING ROCK RD STE A1",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286074600",
            "telephone_number": "828-264-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM C HENSON OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-11",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A",
        "authorized_official_last_name": "HENSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "828-264-2020",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blue Ridge Vision",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Blue Ridge Vision",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Daniel J Sullivan OD PA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Boone, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.