DRS Simon & Medlock Prtnr

Primary specialty

OptometristTaxonomy code 152W00000X

License

S587TA195; S592TA197 Issued in AL

Legal business name

DRS SIMON & MEDLOCK PRTNR

Practice address

832 Princeton Ave SW
Birmingham, AL 35211-1320

Phone

(205) 780-7053

Fax

(205) 206-8368

NPI assigned

Sep 28, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Ronald David Medlock, ODNPI 1730271701

Title

Partner

Phone

(205) 560-0477

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Practitioners 2

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

• Ronald D. Medlock, OD

  • Optometrist
  • Birmingham, AL
  • NPI 1730271701
  Medicare reassignment NPD Authorized official
• Gerald Simon, O.D.

  • Optometrist
  • Trussville, AL
  • NPI 1386654739
  Medicare reassignment NPD

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289520000000",
    "number": "1811089808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 360064",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352360064",
            "telephone_number": "205-560-0477",
            "fax_number": "205-560-0477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "832 PRINCETON AVE SW",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352111320",
            "telephone_number": "205-780-7053",
            "fax_number": "205-206-8368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRS SIMON & MEDLOCK PRTNR",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2010-11-12",
        "status": "A",
        "authorized_official_last_name": "MEDLOCK",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "205-560-0477",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S587TA195; S592TA197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "E659",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Judith E Drews, PH.D., RPT
• Dwight David Driskell, CRNA
• Deborah C Driskill, NNP
• Daniel Droukas, MD
• DRS Hudgens Swillie Russell and Strong
• DRS Turnbull & Coburn PC
• DRS. Alling & Alling, PC
• DRS. Boger & Solomon, P.C.
• DRS. Bowen & Kowalski, LLP
• DRS. Chadband & Rowland, P.C.

• Optometrist in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Optometrist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2010; 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.