Individual provider Active NPI

Richard B. Anderson, O.D.

  • Optometrist
  • Denver, CO
National Provider Identifier
1821160102
Registry record updated Jun 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPV.0000003 Issued in CO
Practice address
3900 E Mexico Ave Ste 102
Denver, CO 80210-3941
Phone
(720) 524-1001
Fax
(720) 524-1121
NPI assigned
Nov 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X CO 1350 CO
Optometrist 152W00000X OPV.0000003 CO Primary

Addresses

Primary practice location

3900 E Mexico Ave Ste 102
Denver, CO 80210-3941

Mailing address

3900 E Mexico Ave Ste 102
Denver, CO 80210-3941
Phone (720) 524-1001

Other identifiers 1

IdentifierTypeStateIssuer
08012494MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CO 1350COMDOptometrist
OPV.0000003COMDOptometrist
369NMMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rocky Mountain Eye Center, Inc. a Colorado Provider Network Optometrist Past Accepting new patients

Organizations & group practices 1

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": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465344000000",
    "number": "1821160102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 E MEXICO AVE STE 102",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802103941",
            "telephone_number": "720-524-1001",
            "fax_number": "720-524-1121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 E MEXICO AVE STE 102",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802103941",
            "telephone_number": "720-524-1001",
            "fax_number": "720-524-1121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "RICHARD",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2016-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "CO 1350",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "OPV.0000003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08012494",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2016; 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.