Individual provider Active NPI

William Harrison, OD

  • Optometrist
  • Boone, NC
National Provider Identifier
1851152755
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2783 Issued in NC
Practice address
1180 Blowing Rock Rd Ste A1
Boone, NC 28607-4600
Phone
(828) 264-2020
NPI assigned
Jan 17, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2783 NC Primary

Addresses

Primary practice location

1180 Blowing Rock Rd Ste A1
Boone, NC 28607-4600

Mailing address

133 Snow Plow Rd
Banner Elk, NC 28604

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20240429000075 NC Practitioner - Optometry 2264872027 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2783NCMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Optometric Eye Clinic, P.a. Optometrist CurrentSince Mar 9, 2024 Accepting new patients
Vision Loft, O.D., P.a. Optometrist CurrentSince May 2, 2024 Accepting new patients
William C Henson OD PA Optometrist CurrentSince Jan 21, 2024 Accepting new patients

Locations

1180 Blowing Rock Rd
Ste A1
Boone, NC 28607
Phone (828) 264-2020

8415 Pit Stop Ct NW
Ste 100
Concord, NC 28027
Phone (704) 785-8070

622 N Main St
Mooresville, NC 28115
Phone (704) 664-5406

Organizations & group practices 3

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": "1705449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1851152755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 SNOW PLOW RD",
            "city": "BANNER ELK",
            "state": "NC",
            "postal_code": "28604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 BLOWING ROCK RD STE A1",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286074600",
            "telephone_number": "828-264-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-17",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boone, NC

Sources for this page

Verify at the official NPI Registry.