NPIMap

Organization Active NPI

Michael G Pharris OD PC

  • Optometrist
  • Baltimore, MD
National Provider Identifier
1205006145
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MICHAEL G PHARRIS OD PC
Practice address
1253 W Pratt St
Baltimore, MD 21223-2684
Phone
(410) 727-4746
Fax
(410) 727-6767
NPI assigned
Mar 6, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2025

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

Authorized official

Name
Ms. Samantha B Leblanc
Title
Credentialing Specialist
Phone
(719) 323-2372

Specialties & licenses 1

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

Addresses

Primary practice location

1253 W Pratt St
Baltimore, MD 21223-2684

Mailing address

2221 E Bijou St.
Ste. 100
Colorado Springs, CO 80909
Phone (410) 727-4746

Other identifiers 1

IdentifierTypeStateIssuer
304036400MedicaidMD

Other names 1

  • Adventure Dental and Vision Doing business as

National Provider Directory

National Provider Directory

Locations

2440 S Academy Blvd
Colorado Springs, CO 80916

1253 W Pratt St
Baltimore, MD 21223
Phone (410) 727-4746

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1204761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757376000000",
    "number": "1205006145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2221 E BIJOU ST.",
            "address_2": "STE. 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80909",
            "telephone_number": "410-727-4746",
            "fax_number": "410-727-6767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1253 W PRATT ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212232684",
            "telephone_number": "410-727-4746",
            "fax_number": "410-727-6767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL G PHARRIS OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-06",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A",
        "authorized_official_last_name": "LEBLANC",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "719-323-2372",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "304036400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Adventure Dental and Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2025; 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.