Chad Brewer, OD PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

S-A64-TA-625 Issued in AL

Legal business name

CHAD BREWER, OD PC

Doing business as

Shoals Eye Clinic

Practice address

2126 Helton Dr
Florence, AL 35630-1449

Phone

(256) 766-5405

NPI assigned

Jan 5, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Marty Chadwick Brewer, O.D.NPI 1508973264

Title

President

Phone

(256) 766-5405

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Shoals Eye Clinic Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Marty Chadwick Brewer, O.D.

  • Corneal and Contact Management Optometrist
  • Florence, AL
  • NPI 1508973264
  NPD (past) Authorized official

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223337600000",
    "number": "1033267398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2126 HELTON DR",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356301449",
            "telephone_number": "256-766-5405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2126 HELTON DR",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356301449",
            "telephone_number": "256-766-5405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAD BREWER, OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2008-10-07",
        "status": "A",
        "authorized_official_last_name": "BREWER",
        "authorized_official_first_name": "MARTY",
        "authorized_official_middle_name": "CHADWICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "256-766-5405",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S-A64-TA-625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529920500",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shoals Eye Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2008; 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.