Individual provider Active NPI

Ron G Fair, OD

  • Optometrist
  • Brighton, CO
National Provider Identifier
1376536268
Registry record updated May 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
645 Issued in CO
Practice address
1001 E Bridge St Ste a
Brighton, CO 80601-2275
Phone
(303) 659-3036
Fax
(303) 659-0053
NPI assigned
Aug 25, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 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 645 CO Primary

Addresses

Primary practice location

1001 E Bridge St Ste a
Brighton, CO 80601-2275

Mailing address

1001 E Bridge St Ste a
Brighton, CO 80601-2276
Phone (303) 659-3036

Other identifiers 2

IdentifierTypeStateIssuer
08006454MedicaidCO
C1376536268OtherCONPI NUMBER

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

LicenseStateTypeSpecialty
645COMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Brighton Eye Associates PC Optometrist PastSince Jan 26, 1998 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210550400000",
    "number": "1376536268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 E BRIDGE ST STE A",
            "city": "BRIGHTON",
            "state": "CO",
            "postal_code": "806012276",
            "telephone_number": "303-659-3036",
            "fax_number": "303-659-0053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 E BRIDGE ST STE A",
            "city": "BRIGHTON",
            "state": "CO",
            "postal_code": "806012275",
            "telephone_number": "303-659-3036",
            "fax_number": "303-659-0053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIR",
        "first_name": "RON",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-25",
        "last_updated": "2008-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "645",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08006454",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NUMBER",
            "identifier": "C1376536268",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brighton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 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.