Active NPI
Bren Alden Myers, O.D.
- Optometrist
- Beloit, KS
National Provider Identifier
1053408575
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1039-3
- Practice address
- 124 N Mill
Beloit, KS 67420-3239 - Phone
- (785) 738-3816
- Fax
- (785) 738-4320
- NPI assigned
- Oct 6, 2006
- Last updated
- Jun 2, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1039-3 | KS | Primary |
Addresses
Primary practice location
124 N Mill
Beloit, KS 67420-3239
Mailing address
124 N Mill
Beloit, KS 67420-3239
Phone (785) 738-3816
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100090890D | Medicaid | KS |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1401667200000",
"number": "1053408575",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "124 N MILL",
"city": "BELOIT",
"state": "KS",
"postal_code": "674203239",
"telephone_number": "785-738-3816",
"fax_number": "785-738-4320"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "124 N MILL",
"city": "BELOIT",
"state": "KS",
"postal_code": "674203239",
"telephone_number": "785-738-3816",
"fax_number": "785-738-4320"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MYERS",
"first_name": "BREN",
"middle_name": "ALDEN",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-06",
"last_updated": "2014-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "KS",
"license": "1039-3",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100090890D",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Beloit, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.