Individual provider Active NPI

Rebecca Jean Williamson Brown, O.D.

  • Optometrist
  • Salem, OH
National Provider Identifier
1528021763
Registry record updated Feb 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5423 Issued in OH
Practice address
389 N Ellsworth Ave
Salem, OH 44460-2805
Phone
(330) 332-1200
Fax
(330) 332-1200
NPI assigned
Apr 10, 2006
Last updated
Feb 11, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5423 OH Primary

Addresses

Primary practice location

389 N Ellsworth Ave
Salem, OH 44460-2805

Mailing address

389 N Ellsworth Ave
Salem, OH 44460-2805
Phone (330) 332-1200

Other names 1

  • Dr. Rebecca Jean Williamson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20060404000025 OH Practitioner - Optometry 1153339080 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

389 N Ellsworth Ave
Salem, OH 44460-2805
Phone (330) 332-1200

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5423OHMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Rebecca J W Brown LLC Optometrist CurrentSince Mar 4, 2012 Accepting new patients
Willard J. Stamp PastSince Mar 4, 2012 Accepting new patients
Thomas M. Grischow, O.D., Inc. Optometrist Past Accepting new patients
Thomas M Grischow OD Inc Optometrist Past Accepting new patients

Locations

389 N Ellsworth Ave
Salem, OH 44460
Phone (330) 332-1200

Organizations & group practices 4

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": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581379200000",
    "number": "1528021763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "389 N ELLSWORTH AVE",
            "city": "SALEM",
            "state": "OH",
            "postal_code": "444602805",
            "telephone_number": "330-332-1200",
            "fax_number": "330-332-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "389 N ELLSWORTH AVE",
            "city": "SALEM",
            "state": "OH",
            "postal_code": "444602805",
            "telephone_number": "330-332-1200",
            "fax_number": "330-332-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "REBECCA",
        "middle_name": "JEAN WILLIAMSON",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-10",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "WILLIAMSON",
            "middle_name": "JEAN",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Salem, OH

Sources for this page

Verify at the official NPI Registry.