Individual provider Active NPI

Herman Salmenson, OD

  • Optometrist
  • Alpharetta, GA
National Provider Identifier
1720022916
Registry record updated Jun 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT001350 Issued in GA
Practice address
9875 Medlock Bridge Parkway
Suite 100
Alpharetta, GA 30022
Phone
(770) 813-0026
Fax
(770) 813-0029
NPI assigned
Jun 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT001350 GA Primary

Addresses

Primary practice location

9875 Medlock Bridge Parkway
Suite 100
Alpharetta, GA 30022

Mailing address

9875 Medlock Bridge Pkwy Ste 100
Alpharetta, GA 30022-6640
Phone (770) 813-0026

Other identifiers 1

IdentifierTypeStateIssuer
00319514MedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20101005001016 GA Practitioner - Optometry 1153513478

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275609600000",
    "number": "1720022916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9875 MEDLOCK BRIDGE PKWY STE 100",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300226640",
            "telephone_number": "770-813-0026",
            "fax_number": "770-813-0029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9875 MEDLOCK BRIDGE PARKWAY",
            "address_2": "SUITE 100",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "30022",
            "telephone_number": "770-813-0026",
            "fax_number": "770-813-0029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALMENSON",
        "first_name": "HERMAN",
        "name_prefix": "Mr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2010-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT001350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00319514",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

Verify at the official NPI Registry.