Individual provider Active NPI

Harold Eugene Harrison, O.D.

  • Optometrist
  • Rainbow City, AL
National Provider Identifier
1619042850
Registry record updated Dec 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
07005077 Issued in AL
Practice address
115 W Grand Ave
Suite 120
Rainbow City, AL 35906-3275
Phone
(205) 442-9350
Fax
(256) 442-9352
NPI assigned
Nov 22, 2006
Last updated
Dec 31, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 31, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 07005077 AL Primary

Addresses

Primary practice location

115 W Grand Ave
Suite 120
Rainbow City, AL 35906-3275

Mailing address

115 W Grand Ave
Suite 120
Rainbow City, AL 35906-3275
Phone (205) 442-9350

Other identifiers 2

IdentifierTypeStateIssuer
051523183OtherALBLUE CROSS/BLUE SHIELD
051523183MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20040812000484 AL Practitioner - Optometry 6406828904 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vision Source, Inc.Group PAC ID 4981676483, 3 clinicians

Practice addresses (Care Compare)

156 Main St
Trussville, AL 35173-1446
Phone (205) 520-9002

2040 2ND Ave E
Suite B
Oneonta, AL 35121-2820
Phone (205) 625-3937

2040 2ND Ave E B
Oneonta, AL 35121-2820

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery23

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
07005077ALMDOptometrist
5732ALMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Source, Inc. Optometrist CurrentSince Jan 1, 2004 Accepting new patients
Vision Source, Inc. Optometrist CurrentSince Sep 1, 1991 Accepting new patients
Rainbow City Family Eye Care LLC Optometrist CurrentSince Jul 12, 1999 Accepting new patients
Rainbow City Family Eye Care, LLC Current Accepting new patients
Dr. April R. King, OD, LLC Optometrist PastSince Sep 26, 2007 Accepting new patients

Locations

5590 Chalkville Rd
Ste B
Birmingham, AL 35235
Phone (205) 520-9002

2040 2nd Ave E
Ste B
Oneonta, AL 35121
Phone (205) 520-9002

115 W Grand Ave
Ste 120
Rainbow City, AL 35906
Phone (256) 442-9350

156 Main St
Trussville, AL 35173
Phone (205) 520-9002

Organizations & group practices 5

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": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356912000000",
    "number": "1619042850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 W GRAND AVE",
            "address_2": "SUITE 120",
            "city": "RAINBOW CITY",
            "state": "AL",
            "postal_code": "359063275",
            "telephone_number": "205-442-9350",
            "fax_number": "256-442-9352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 W GRAND AVE",
            "address_2": "SUITE 120",
            "city": "RAINBOW CITY",
            "state": "AL",
            "postal_code": "359063275",
            "telephone_number": "205-442-9350",
            "fax_number": "256-442-9352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "HAROLD",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2012-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "07005077",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "051523183",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051523183",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rainbow City, AL

Sources for this page

Verify at the official NPI Registry.