Individual provider Active NPI

Ronald L McCann, OD

  • Optometrist
  • Hudson, WI
National Provider Identifier
1609925692
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1956 Issued in WI
Practice address
113 Carmichael Rd
Hudson, WI 54016-7716
Phone
(715) 377-7970
Fax
(716) 377-7974
NPI assigned
Jan 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1954 MN
Optometrist 152W00000X 1956 WI Primary

Addresses

Primary practice location

113 Carmichael Rd
Hudson, WI 54016-7716

Mailing address

113 Carmichael Rd
Hudson, WI 54016-7716
Phone (715) 377-7970

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20060207000391 WI Practitioner - Optometry 0941215388 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1956WIMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Sees the Day LTD CurrentSince May 20, 2019 Accepting new patients
Sees the Day LTD Optometrist CurrentSince May 20, 2019 Accepting new patients

Locations

7150 Valley Creek Plz
Ste 216
Woodbury, MN 55125
Phone (651) 738-4886

113 Carmichael Rd
Hudson, WI 54016
Phone (715) 377-7970

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": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1609925692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 CARMICHAEL RD",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540167716",
            "telephone_number": "715-377-7970",
            "fax_number": "716-377-7974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 CARMICHAEL RD",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540167716",
            "telephone_number": "715-377-7970",
            "fax_number": "716-377-7974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCANN",
        "first_name": "RONALD",
        "middle_name": "L",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "1954",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "1956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, WI

Sources for this page

Verify at the official NPI Registry.