Organization Active NPI

Phillips Salomon & Parrish PA

  • Optometrist
  • Lakeland, FL
National Provider Identifier
1548257264
Registry record updated Feb 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
PHILLIPS SALOMON & PARRISH PA
Practice address
4337 S Florida Ave
Lakeland, FL 33813-1654
Phone
(863) 619-6900
Fax
(863) 648-4679
NPI assigned
Sep 29, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2011

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

Authorized official

Name
Dr. Brad R Salomon, OD
Title
Registered Agent
Phone
(863) 299-8908

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

4337 S Florida Ave
Lakeland, FL 33813-1654

Mailing address

215 1St St N
Suite 100
Winter Haven, FL 33881-4537
Phone (863) 299-8908

Other identifiers 1

IdentifierTypeStateIssuer
078873201MedicaidFL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297123200000",
    "number": "1548257264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 1ST ST N",
            "address_2": "SUITE 100",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338814537",
            "telephone_number": "863-299-8908",
            "fax_number": "863-299-1061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4337 S FLORIDA AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338131654",
            "telephone_number": "863-619-6900",
            "fax_number": "863-648-4679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILLIPS SALOMON & PARRISH PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-29",
        "last_updated": "2011-02-08",
        "status": "A",
        "authorized_official_last_name": "SALOMON",
        "authorized_official_first_name": "BRAD",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "REGISTERED AGENT",
        "authorized_official_telephone_number": "863-299-8908",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "078873201",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2011; 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.