Bradly Kendall Larson, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1775-709T Issued in LA

Practice address

8889 Jewella Ave Ste C
Shreveport, LA 71118-2138

Phone

(318) 686-5227

Fax

(381) 686-5283

NPI assigned

Aug 1, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

University of Houston - College of Optometry, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• LA PPO C-SNP

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.

• Golden Eye Central, PLLC

  • Optometrist
  • Carthage, TX
  • NPI 1558904466
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1406851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406851200000",
    "number": "1053729152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8889 JEWELLA AVE STE C",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711182138",
            "telephone_number": "318-686-5227",
            "fax_number": "381-686-5283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8889 JEWELLA AVE STE C",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711182138",
            "telephone_number": "318-686-5227",
            "fax_number": "381-686-5283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "BRADLY",
        "middle_name": "KENDALL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-01",
        "last_updated": "2014-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "LA",
            "license": "1775-709T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melvin Lars
• Yolanda Lars
• Larsen Physical Therapy, Inc.
• Larry Nels Larsen, P.T., A.T.C., S.T.S.
• Andrew W Larson, MD
• Amanda Gail Lary, PHARM.D.
• Addison Ruth Lasater, PA-C
• Laser & Cataract Center of Shreveport LLC
• Tyler Donald Lash, M.D.
• Cody Stutson Lasiter, PT, DPT

• Optometrist in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Optometrist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2014; 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.