Bruce Edwin Reid, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1114T Issued in GA

Practice address

400 Ernest W Barrett Pkwy NW
Suite 297
Kennesaw, GA 30144-4917

Phone

(770) 421-1734

NPI assigned

Jul 9, 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.

• Dr. Bruce E. Reid and Associates, PC

  • Optometrist
  • Kennesaw, GA
  • NPI 1568596500
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104859461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 ERNEST W BARRETT PKWY NW",
            "address_2": "SUITE 297",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301444917",
            "telephone_number": "770-421-1734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 ERNEST W BARRETT PKWY NW",
            "address_2": "SUITE 297",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301444917",
            "telephone_number": "770-421-1734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REID",
        "first_name": "BRUCE",
        "middle_name": "EDWIN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "1114T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Owen Reeves, PA-C
• Andrea Lee Reeves, D.C.
• Refined Beginnings Counseling LLC
• Regency Hospice of Georgia, LLC
• Amy Leigh Reich, D.C.
• Kimberly Reid, RN
• Pamela Jaycille Reid
• Sean Michael Reilly, L.C.S.W.
• Courtney Nicole Reina, FNP
• Amarae Reinard

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.