Organization Active NPI

Noron, Inc

  • Optometrist
  • Peoria, IL
National Provider Identifier
1124263017
Registry record updated May 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046007514 Issued in IL
Legal business name
NORON, INC
Practice address
456 Fulton St
Suite 140
Peoria, IL 61602-1274
Phone
(309) 674-6633
Fax
(309) 674-6694
NPI assigned
Dec 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2010

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

Authorized official

Name
Dr. Rhonda V Dameron, O.D.
Title
Owner
Phone
(309) 674-6633

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 046007514 IL Primary

Addresses

Primary practice location

456 Fulton St
Suite 140
Peoria, IL 61602-1274

Mailing address

456 Fulton St
Suite 140
Peoria, IL 61602-1274
Phone (309) 674-6633

Other identifiers 1

IdentifierTypeStateIssuer
046007514MedicaidIL

Other names 1

  • Optik Boutique Doing business as

National Provider Directory

National Provider Directory

Locations

456 Fulton St
Peoria, IL 61602
Phone (309) 674-6633

456 Fulton St
Ste 140
Peoria, IL 61602
Phone (309) 674-6633

NPI Registry JSON

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

{
    "created_epoch": "1228694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274054400000",
    "number": "1124263017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "456 FULTON ST",
            "address_2": "SUITE 140",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616021274",
            "telephone_number": "309-674-6633",
            "fax_number": "309-674-6694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "456 FULTON ST",
            "address_2": "SUITE 140",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616021274",
            "telephone_number": "309-674-6633",
            "fax_number": "309-674-6694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORON, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-08",
        "last_updated": "2010-05-17",
        "status": "A",
        "authorized_official_last_name": "DAMERON",
        "authorized_official_first_name": "RHONDA",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "309-674-6633",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046007514",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046007514",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optik Boutique",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2010; 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.