Individual provider Active NPI

Ralph Henry, OD

  • Optometrist
  • Monroe, WI
National Provider Identifier
1689748055
Registry record updated Dec 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2080 Issued in WI
Practice address
515 22ND Ave
Monroe, WI 53566-1569
Phone
(608) 324-2000
NPI assigned
Nov 20, 2006
Last updated
Dec 18, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2080 WI Primary

Addresses

Primary practice location

515 22ND Ave
Monroe, WI 53566-1569

Mailing address

515 22ND Ave
Monroe, WI 53566-1569
Phone (608) 324-2000

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address rhenry3513@direct.monroeclinic.org Direct
FHIR URL https://webproxyprd.monroeclinic.org/FHIR-PRD/api/FHIR/DSTU2/ Other

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
I20050607000417 WI Practitioner - Optometry 9234172628 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2080WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Monroe Clinic, Inc. CurrentSince Jun 1, 2005 Accepting new patients
The Monroe Clinic, Inc. CurrentSince Jun 1, 2005 Accepting new patients

Locations

2009 5th St
Monroe, WI 53566
Phone (608) 324-1454

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

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, 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": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1689748055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 22ND AVE",
            "city": "MONROE",
            "state": "WI",
            "postal_code": "535661569",
            "telephone_number": "608-324-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 22ND AVE",
            "city": "MONROE",
            "state": "WI",
            "postal_code": "535661569",
            "telephone_number": "608-324-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "RALPH",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rhenry3513@direct.monroeclinic.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "rhenry3513@direct.monroeclinic.org",
            "address_1": "515 22nd Ave",
            "city": "Monroe",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535661569",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://webproxyprd.monroeclinic.org/FHIR-PRD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "515 22nd Ave",
            "city": "Monroe",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535661569",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Monroe, WI

Sources for this page

Verify at the official NPI Registry.