Richard Davison, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1993 Issued in WI

Practice address

4301 W Wisconsin Ave
Appleton, WI 54913-8605

Phone

(920) 731-6116

Fax

(920) 731-6119

NPI assigned

Nov 7, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 1984

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Partnership Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Appleton, WI
  • NPI 1225074008

  Corporate Director

  CMS ownership

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.

• Dr Rick Davison and Assoc, LLC

  • Optometrist
  • Appleton, WI
  • NPI 1154521144
  NPD (past) Authorized official

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629147137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 W WISCONSIN AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138605",
            "telephone_number": "920-731-6116",
            "fax_number": "920-731-6119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 W WISCONSIN AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138605",
            "telephone_number": "920-731-6116",
            "fax_number": "920-731-6119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVISON",
        "first_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "1993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "39788727",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hannah M Davies, PA-C
• Amy Davis
• Bruce Davis, SAC
• Jane M Davis
• Kristina Starr Davis, LCSW
• Gina M Day, LPC
• Kristin Day, NP
• Jennifer De la Paz, PHARMD
• Elena De Los Santos
• Paul De Montaudouin, DO

• Optometrist in Appleton, WI
• Providers in Appleton, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.