Individual provider Active NPI

Laurence Biddle Danson, OD

  • Optometrist
  • Roseburg, OR
National Provider Identifier
1679797666
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4032T Issued in OR
Practice address
780 NW Garden Valley Blvd
#50B1
Roseburg, OR 97470
Phone
(541) 957-5249
NPI assigned
Apr 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4032T OR Primary

Addresses

Primary practice location

780 NW Garden Valley Blvd
#50B1
Roseburg, OR 97470

Mailing address

2435 West Luellen Drive
Roseburg, OR 97470
Phone (541) 957-5249

Other identifiers 1

IdentifierTypeStateIssuer
076195MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20090709000766 OR Practitioner - Optometry 2062564768 Practice locations: Roseburg, OR

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

780 NW Garden Valley Blvd
Suite 50B1
Roseburg, OR 97471-6528
Phone (541) 957-5249

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery63

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4032TORMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Opticians Inc. Past Accepting new patients

Organizations & group practices 1

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": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679797666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2435 WEST LUELLEN DRIVE",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "97470",
            "telephone_number": "541-957-5249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 NW GARDEN VALLEY BLVD",
            "address_2": "#50B1",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "97470",
            "telephone_number": "541-957-5249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANSON",
        "first_name": "LAURENCE",
        "middle_name": "BIDDLE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "4032T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "076195",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseburg, OR

Sources for this page

Verify at the official NPI Registry.