NPIMap

Organization Active NPI

Dr John C Dragon OD & Associates

  • Optometrist
  • Norfolk, VA
National Provider Identifier
1720177322
Registry record updated Nov 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
DR JOHN C DRAGON OD & ASSOCIATES
Practice address
7525 Tidewater Dr
Suite 41
Norfolk, VA 23505-3700
Phone
(757) 588-5423
Fax
(757) 588-6012
NPI assigned
Oct 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2019

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

Authorized official

Name
Dr. John Christopher Dragon, O.D.NPI 1083701544
Title
Partner
Phone
(757) 588-5423

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

7525 Tidewater Dr
Suite 41
Norfolk, VA 23505-3700

Mailing address

7525 Tidewater Dr
Suite 41
Norfolk, VA 23505-3700
Phone (757) 588-5423

Other identifiers 1

IdentifierTypeStateIssuer
9234462MedicaidVA

Other names 2

  • SOUTHERN EYECARE ASSOCIATES Doing business as
  • Southern Eyecare Associates, Optometrists Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080716000363 VA Part B Supplier - Clinic/Group Practice 6103999677 Receives reassigned benefits from 3 practitioners
Practice locations: Norfolk, VA

National Provider Directory

National Provider Directory

Locations

7525 Tidewater Dr
Ste 41
Norfolk, VA 23505
Phone (757) 588-5423

7525 Tidewater Dr
Norfolk, VA 23505

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574035200000",
    "number": "1720177322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7525 TIDEWATER DR",
            "address_2": "SUITE 41",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235053700",
            "telephone_number": "757-588-5423",
            "fax_number": "757-588-6012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7525 TIDEWATER DR",
            "address_2": "SUITE 41",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235053700",
            "telephone_number": "757-588-5423",
            "fax_number": "757-588-6012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR JOHN C DRAGON OD & ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2019-11-18",
        "status": "A",
        "authorized_official_last_name": "DRAGON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "757-588-5423",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9234462",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTHERN EYECARE ASSOCIATES",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southern Eyecare Associates, Optometrists",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southern Eyecare Associates, Optometrists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.