Jerry Samuel Hardison, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

851 Issued in CT

Practice address

553 Farmington Ave
Hartford, CT 06105-3048

Phone

(860) 236-5831

Fax

(860) 236-2966

NPI assigned

Jun 17, 2005

Last updated

Feb 8, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• West End Eye Care LLC

  • Optometrist
  • Hartford, CT
  • NPI 1275684037
  Authorized official Same address or phone

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

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202428800000",
    "number": "1306841077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "553 FARMINGTON AVE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061053048",
            "telephone_number": "860-236-5831",
            "fax_number": "860-236-2966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "553 FARMINGTON AVE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061053048",
            "telephone_number": "860-236-5831",
            "fax_number": "860-236-2966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDISON",
        "first_name": "JERRY",
        "middle_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-17",
        "last_updated": "2008-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4024659",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Haymara Harakas, M.A.
• Harc Inc. (Stepping Stones)
• Harc, Inc. (Harc Behavioral Health Clinic)
• Harc, Inc.
• Rachael A Hardee
• Nylsa Hardy
• Warren Hardy II
• Christina Hare
• Zeev Harel, MD
• Jaimie Harlow

• Optometrist in Hartford, CT
• Providers in Hartford, CT by specialty
• Optometrist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 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.

Verify at the official NPI Registry.