Active NPI
Ronald B. Mori, O.D.
- Optometrist
- Sacramento, CA
National Provider Identifier
1154407278
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 5184
- Practice address
- 4617 Freeport Blvd
Suite D
Sacramento, CA 95822-2015 - Phone
- (916) 452-4439
- Fax
- (916) 452-3432
- NPI assigned
- Oct 31, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 | 5184 | CA | Primary |
Addresses
Primary practice location
4617 Freeport Blvd
Suite D
Sacramento, CA 95822-2015
Mailing address
4617 Freeport Blvd
Suite D
Sacramento, CA 95822-2015
Phone (916) 452-4439
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 |
|---|---|---|---|
| 5184 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217376000000",
"number": "1154407278",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4617 FREEPORT BLVD",
"address_2": "SUITE D",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958222015",
"telephone_number": "916-452-4439",
"fax_number": "916-452-3432"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4617 FREEPORT BLVD",
"address_2": "SUITE D",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958222015",
"telephone_number": "916-452-4439",
"fax_number": "916-452-3432"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORI",
"first_name": "RONALD",
"middle_name": "B.",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-31",
"last_updated": "2008-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "5184",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.