Individual provider Active NPI

Ronald C Harrison, O.D.

  • Optometrist
  • Santa Rosa, CA
National Provider Identifier
1588653752
Registry record updated May 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT 6943 TPA Issued in CA
Practice address
2320 Midway Dr
Santa Rosa, CA 95405-5017
Phone
(707) 526-2020
Fax
(707) 526-2032
NPI assigned
Oct 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2000145741 MO
Optometrist 152W00000X 2555T TX
Optometrist 152W00000X OPT 6943 TPA CA Primary

Addresses

Primary practice location

2320 Midway Dr
Santa Rosa, CA 95405-5017

Mailing address

2320 Midway Dr
Santa Rosa, CA 95405-5017
Phone (707) 526-2020

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
OPT 6943 TPACAMDOptometrist
2000145741MOMDOptometrist
2555TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Invision Family Eye Care Optometrist PastSince Jan 1, 2009 Accepting new patients
V G Green PC Inc Optometrist Past Accepting new patients

Organizations & group practices 2

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": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432857600000",
    "number": "1588653752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2320 MIDWAY DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954055017",
            "telephone_number": "707-526-2020",
            "fax_number": "707-526-2032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2320 MIDWAY DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954055017",
            "telephone_number": "707-526-2020",
            "fax_number": "707-526-2032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "RONALD",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-19",
        "last_updated": "2015-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2000145741",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "2555T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT 6943 TPA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2015; 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.