Organization Active NPI

Phillips, Salomon & Parrish, PA

  • Optometrist
  • Haines City, FL
National Provider Identifier
1730242041
Registry record updated Feb 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
PHILLIPS, SALOMON & PARRISH, PA
Practice address
119 Patterson Rd
Haines City, FL 33844-7803
Phone
(863) 419-1300
Fax
(863) 595-2838
NPI assigned
Dec 18, 2006
Last updated
Feb 14, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2011

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

Authorized official

Name
Dr. Brad R Salomon, O.D.
Title
Registered Agent
Phone
(863) 299-8908

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

119 Patterson Rd
Haines City, FL 33844-7803

Mailing address

215 1St St N
Suite 100
Winter Haven, FL 33881-4537
Phone (863) 299-8908

Other identifiers 1

IdentifierTypeStateIssuer
078873206MedicaidFL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297641600000",
    "number": "1730242041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 1ST ST N",
            "address_2": "SUITE 100",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338814537",
            "telephone_number": "863-299-8908",
            "fax_number": "863-595-2838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 PATTERSON RD",
            "city": "HAINES CITY",
            "state": "FL",
            "postal_code": "338447803",
            "telephone_number": "863-419-1300",
            "fax_number": "863-595-2838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILLIPS, SALOMON & PARRISH, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2011-02-14",
        "status": "A",
        "authorized_official_last_name": "SALOMON",
        "authorized_official_first_name": "BRAD",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "REGISTERED AGENT",
        "authorized_official_telephone_number": "863-299-8908",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "078873206",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Haines City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.