Active NPI
Eric Paul Burris, O.D.
- Optometrist
- Tell City, IN
National Provider Identifier
1104964592
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 18002159B
- Practice address
- 715 Main St
Tell City, IN 47586-1705 - Phone
- (812) 547-3396
- Fax
- (812) 547-5272
- NPI assigned
- Feb 1, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 18002159B | IN | Primary |
Addresses
Primary practice location
715 Main St
Tell City, IN 47586-1705
Mailing address
715 Main St
P O Box 457
Tell City, IN 47586-1705
Phone (812) 547-3396
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100203190A | Medicaid | IN | |
| 1285910001 | Other | IN | DMAC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18002159B | IN | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1336694400000",
"number": "1104964592",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "715 MAIN ST",
"address_2": "P O BOX 457",
"city": "TELL CITY",
"state": "IN",
"postal_code": "475861705",
"telephone_number": "812-547-3396",
"fax_number": "812-547-5272"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "715 MAIN ST",
"city": "TELL CITY",
"state": "IN",
"postal_code": "475861705",
"telephone_number": "812-547-3396",
"fax_number": "812-547-5272"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURRIS",
"first_name": "ERIC",
"middle_name": "PAUL",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-01",
"last_updated": "2012-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IN",
"license": "18002159B",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100203190A",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DMAC",
"identifier": "1285910001",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tell City, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.