Active NPI
Paul H Vernon, O.D.
- Optometrist
- Yuma, AZ
National Provider Identifier
1295873453
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 719
- Practice address
- 2900 S Pacific Ave
Yuma, AZ 85365-3500 - Phone
- (928) 314-0103
- Fax
- (928) 314-0119
- NPI assigned
- Feb 1, 2007
- 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 | 719 | AZ | Primary |
Addresses
Primary practice location
2900 S Pacific Ave
Yuma, AZ 85365-3500
Mailing address
7030 N 11TH Way
Phoenix, AZ 85020-5313
Phone (602) 870-4762
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 |
|---|---|---|---|
| 719 | AZ | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1295873453",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7030 N 11TH WAY",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850205313",
"telephone_number": "602-870-4762"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2900 S PACIFIC AVE",
"city": "YUMA",
"state": "AZ",
"postal_code": "853653500",
"telephone_number": "928-314-0103",
"fax_number": "928-314-0119"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VERNON",
"first_name": "PAUL",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "AZ",
"license": "719",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yuma, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.