Paul Wesley Broome, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT848T Issued in GA

Practice address

510 North Belair Road
Evans, GA 30809

Phone

(706) 863-3030

Fax

(706) 863-0093

NPI assigned

May 3, 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

Medicare fee-for-service enrollment

Enrolled in GA

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

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.

• Eyecare One Martinez LLC

  • Optometrist
  • Evans, GA
  • NPI 1043437486
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397606400000",
    "number": "1083672422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 NORTH BELAIR ROAD",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "30809",
            "telephone_number": "706-863-3030",
            "fax_number": "706-863-0093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 NORTH BELAIR ROAD",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "30809",
            "telephone_number": "706-863-3030",
            "fax_number": "706-863-0093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOME",
        "first_name": "PAUL",
        "middle_name": "WESLEY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2014-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT848T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kentarvius Brinkley, RBT
• Destinia Lashawn Brister
• Amone' Brookins
• William S Brooks III, M.D.
• Michael Wesley Broome, O.D.
• Melissa Renee Broske, APRN
• David Daniel Brosnahan, M.D., M.S.
• Bennie Brown Jr., D.O.
• Briana Brown, D.O.
• Janese Adellis Brown, LCSW

• Optometrist in Evans, GA
• Providers in Evans, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.