Organization Active NPI

Bentonville Eye Care PLLC

  • Optometrist
  • Bentonville, AR
National Provider Identifier
1083984116
Registry record updated Apr 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
BENTONVILLE EYE CARE PLLC
Practice address
2300 SE J St Ste 12
Bentonville, AR 72712-3776
Phone
(479) 268-3268
Fax
(479) 268-4019
NPI assigned
Jan 5, 2012
Reactivated
Dec 15, 2025
Last updated
Apr 2, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2026

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

Authorized official

Name
Derrick Pierce, ODNPI 1992997969
Title
Owner / Authorized Official
Phone
(623) 640-6059

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X Primary

Addresses

Primary practice location

2300 SE J St Ste 12
Bentonville, AR 72712-3776

Mailing address

2300 SE J St Ste 12
Bentonville, AR 72712-3776
Phone (479) 268-3268

Other practice location 1

5001 W Pauline Whitaker Pkwy Ste 125
Rogers, AR 72758-7345
Phone (479) 469-2023

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190118000626 AR Part B Supplier - Clinic/Group Practice 3476899030 Receives reassigned benefits from 7 practitioners
Practice locations: Bentonville, AR; Rogers, AR

National Provider Directory

National Provider Directory
Part of
Bentonville Eye Care PLLC

Locations

2300 SE J St
Bentonville, AR 72712
Phone (479) 268-3268

2300 SE J St
Ste 12
Bentonville, AR 72712
Phone (479) 268-3268

800 SE Walton Blvd
Ste 12
Bentonville, AR 72712
Phone (479) 268-3268

5001 W Pauline Whitaker Pkwy
Ste 125
Rogers, AR 72758
Phone (479) 469-2023

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1325721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775088000000",
    "number": "1083984116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 SE J ST STE 12",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123776",
            "telephone_number": "479-268-3268",
            "fax_number": "479-268-4019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 SE J ST STE 12",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123776",
            "telephone_number": "479-268-3268",
            "fax_number": "479-268-4019"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5001 W Pauline Whitaker Pkwy Ste 125",
            "address_purpose": "LOCATION",
            "city": "Rogers",
            "state": "AR",
            "postal_code": "727587345",
            "country_code": "US",
            "telephone_number": "479-469-2023",
            "fax_number": "479-469-2013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BENTONVILLE EYE CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-05",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "deactivation_date": "2025-09-30",
        "reactivation_date": "2025-12-15",
        "status": "A",
        "authorized_official_last_name": "PIERCE",
        "authorized_official_first_name": "DERRICK",
        "authorized_official_title_or_position": "OWNER / AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "623-640-6059",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bentonville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.