Individual provider Active NPI

Harold Eugene Morrill, O.D.

  • Optometrist
  • Jefferson City, TN
National Provider Identifier
1205803582
Registry record updated Mar 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
586 Issued in TN
Practice address
741 E Broadway Blvd
Jefferson City, TN 37760-4907
Phone
(865) 475-8680
Fax
(865) 475-8681
NPI assigned
Mar 4, 2006
Last updated
Mar 27, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 586 TN Primary

Addresses

Primary practice location

741 E Broadway Blvd
Jefferson City, TN 37760-4907

Mailing address

PO Box 247
Jefferson City, TN 37760-0247
Phone (865) 475-8680

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100503000537 TN Practitioner - Optometry 5698803252 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
586TNMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jeremy L Diamond Optometrist Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1141430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206576000000",
    "number": "1205803582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 247",
            "city": "JEFFERSON CITY",
            "state": "TN",
            "postal_code": "377600247",
            "telephone_number": "865-475-8680",
            "fax_number": "865-475-8681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "741 E BROADWAY BLVD",
            "city": "JEFFERSON CITY",
            "state": "TN",
            "postal_code": "377604907",
            "telephone_number": "865-475-8680",
            "fax_number": "865-475-8681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRILL",
        "first_name": "HAROLD",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-04",
        "last_updated": "2008-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson City, TN

Sources for this page

Verify at the official NPI Registry.