NPIMap

Organization Active NPI

Dr Rick Davison and Assoc, LLC

  • Optometrist
  • Appleton, WI
National Provider Identifier
1154521144
Registry record updated Jul 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1993 Issued in WI
Legal business name
DR RICK DAVISON AND ASSOC, LLC
Practice address
4301 W Wisconsin Ave
Appleton, WI 54913-8605
Phone
(920) 731-6116
Fax
(920) 731-6119
NPI assigned
Jul 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2007

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

Authorized official

Name
Dr. Richard Joseph Davison, ODNPI 1629147137
Title
Owner
Phone
(920) 731-6116

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 1993 WI Primary

Addresses

Primary practice location

4301 W Wisconsin Ave
Appleton, WI 54913-8605

Mailing address

4301 W Wisconsin Ave
Appleton, WI 54913-8605
Phone (920) 731-6116

National Provider Directory

National Provider Directory

Locations

4301 W Wisconsin Ave
Appleton, WI 54913
Phone (920) 730-8770

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184803200000",
    "number": "1154521144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 W WISCONSIN AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138605",
            "telephone_number": "920-731-6116",
            "fax_number": "920-731-6119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 W WISCONSIN AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138605",
            "telephone_number": "920-731-6116",
            "fax_number": "920-731-6119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR RICK DAVISON AND ASSOC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-19",
        "last_updated": "2007-07-19",
        "status": "A",
        "authorized_official_last_name": "DAVISON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-731-6116",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WI",
            "license": "1993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2007; 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.