Active NPI
Harold William Pearson, M.D.
- Specialist
- Orange Park, FL
National Provider Identifier
1649231903
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 15694R
- Practice address
- 1564 Kingsley Ave
Orange Park, FL 32073-4511 - Phone
- (800) 636-1701
- Fax
- (866) 693-7090
- NPI assigned
- Mar 28, 2006
- Last updated
- Jun 14, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 15694R | LA | Primary |
Addresses
Primary practice location
1564 Kingsley Ave
Orange Park, FL 32073-4511
Mailing address
1564 Kingsley Ave
Orange Park, FL 32073-4511
Phone (800) 636-1701
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1463264 | Medicaid | LA | |
| ME93259 | Other | FL | MEDICAL LICENSE |
Other names 1
- Dr. Harold William Pearson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 1, 2025 through Jan 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15694R | LA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371168000000",
"number": "1649231903",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1564 KINGSLEY AVE",
"city": "ORANGE PARK",
"state": "FL",
"postal_code": "320734511",
"telephone_number": "800-636-1701",
"fax_number": "866-693-7090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1564 KINGSLEY AVE",
"city": "ORANGE PARK",
"state": "FL",
"postal_code": "320734511",
"telephone_number": "800-636-1701",
"fax_number": "866-693-7090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEARSON",
"first_name": "HAROLD",
"middle_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-03-28",
"last_updated": "2013-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "LA",
"license": "15694R",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1463264",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "ME93259",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "HAROLD",
"last_name": "PEARSON",
"middle_name": "WILLIAM",
"prefix": "DR.",
"credential": "MD",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Orange Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.