MEDICARE: DR. NICHOLAS TODD RANSON M. D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207WX0200X	Ophthalmic Plastic and Reconstructive Surgery Physician	2024004550	MO
2	207W00000X	Ophthalmology Physician	2024004550	MO
3	207WX0200X	Ophthalmic Plastic and Reconstructive Surgery Physician	MD00042059	WA
4	207W00000X	Ophthalmology Physician	MD00042059	WA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
8	P00108507	OTHER	WA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0182076	OTHER	WA	LABOR AND INDUSTRIES
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	KW906	OTHER	ID	BLUE CROSS OF IDAHO
4	000010147398	OTHER	ID	ASURIS (REGENCE BS OF ID)
5	806847202	OTHER	ID	PUBLIC ASSISTANCE
6	S 9296RA	OTHER	WA	ASURIS (REGENCE NW HEALTH
7	A034	OTHER	WA	TRICARE
9	WA 0690	OTHER	WA	NORTHWEST BENEFIT NETWORK

General Provider Information

NPI Number	:	1790783041
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NICHOLAS TODD RANSON M. D.

Provider Business Mailing Address
First Line	:	929 BUSINESS PARK DR
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49686-8683
Country	:	US
Telephone Number	:	231-594-7062
Fax Number	:	231-594-7886

Provider Business Practice Location Address
First Line	:	929 BUSINESS PARK DR
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49686-8683
Country	:	US
Telephone Number	:	231-947-6246
Fax Number	:	231-947-8864

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2005
Last Update Date	:	06/14/2024

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Directions to “ DR. NICHOLAS TODD RANSON M. D.” Practice Location

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