Larry D Coon, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT T 103 Issued in AK

Practice address

116 Minnie St
Fairbanks, AK 99701-3006

Phone

(907) 456-7760

Fax

(907) 451-7916

NPI assigned

Jan 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AK

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

Specialty

Optometry

Education

Pacific University - College of Optometry, 1975

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eye Clinic of Fairbanks IncGroup PAC ID 7719878370, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Eye Clinic of Fairbanks, Inc

  • Ophthalmology Physician
  • Fairbanks, AK
  • NPI 1689903965

  Optometrist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480377600000",
    "number": "1881673853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 MINNIE ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997013006",
            "telephone_number": "907-456-7760",
            "fax_number": "907-451-7916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 MINNIE ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997013006",
            "telephone_number": "907-456-7760",
            "fax_number": "907-451-7916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COON",
        "first_name": "LARRY",
        "middle_name": "D",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2016-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AK",
            "license": "OPT T 103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OD33611",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Shawn Cook
• Skylar Cook, BS
• Delys Cooks, CNM
• Benjamin Coomer
• Joy Coon, O.P.
• Fancis Cooney
• Amelia Cooper-Davis
• Alasya Cooper
• Aleasya Cooper
• Allison Cooper, PA-C

• Optometrist in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Optometrist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.