Individual provider Active NPI

Harry Davis, O.D.

  • Optometrist
  • Urbana, OH
National Provider Identifier
1700855111
Registry record updated Mar 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5021-T1898 Issued in OH
Practice address
888 E Court St
Urbana, OH 43078-1835
Phone
(937) 653-5005
Fax
(937) 653-5363
NPI assigned
Mar 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 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 5021-T1898 OH Primary

Addresses

Primary practice location

888 E Court St
Urbana, OH 43078-1835

Mailing address

888 E Court St
Urbana, OH 43078-1835
Phone (937) 653-5005

Other identifiers 8

IdentifierTypeStateIssuer
4396320001OtherOHADMINSTAR FEDERAL
2278253MedicaidOH
OH1898OtherOHEYEMED
410047132OtherOHRAILROAD MEDICARE
23034OtherOHSPECTERA
311811075OtherOHWORKMAN COMP
7986032OtherOHAETNA
33287OtherOHCOORDINATED VISION CARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20120329000451 OH Practitioner - Optometry 6406961648 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aeg Ohio Professional PCGroup PAC ID 7618207036, 80 clinicians

Practice addresses (Care Compare)

1711 S Main St
Bellefontaine, OH 43311-1509
Phone (937) 592-5005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5021-T1898OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Aeg Ohio Professional PC Optometrist CurrentSince Aug 20, 2021 Accepting new patients
Aeg Ohio Professional PC Optometrist CurrentSince Aug 20, 2021 Accepting new patients

Locations

1711 S Main St
Bellefontaine, OH 43311
Phone (513) 592-5005

33541 Aurora Rd
Solon, OH 44139
Phone (440) 248-2020

888 E Court St
Urbana, OH 43078
Phone (937) 652-1144

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331164800000",
    "number": "1700855111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "888 E COURT ST",
            "city": "URBANA",
            "state": "OH",
            "postal_code": "430781835",
            "telephone_number": "937-653-5005",
            "fax_number": "937-653-5363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 E COURT ST",
            "city": "URBANA",
            "state": "OH",
            "postal_code": "430781835",
            "telephone_number": "937-653-5005",
            "fax_number": "937-653-5363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "HARRY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2012-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5021-T1898",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADMINSTAR FEDERAL",
            "identifier": "4396320001",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2278253",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "OH1898",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410047132",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "23034",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKMAN COMP",
            "identifier": "311811075",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7986032",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COORDINATED VISION CARE",
            "identifier": "33287",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbana, OH

Sources for this page

Verify at the official NPI Registry.