Organization Active NPI

Dr. Bruce a. Perry OD

  • Durable Medical Equipment & Medical Supplies
  • Fayette, AL
National Provider Identifier
1114197720
Registry record updated Mar 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
S449TA072 Issued in AL
Legal business name
DR. BRUCE A. PERRY OD
Practice address
124 16TH St NE
Fayette, AL 35555-1340
Phone
(205) 932-5286
NPI assigned
Mar 11, 2008
Last updated
Mar 13, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2008

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

Authorized official

Name
Dr. Bruce A Perry, O.D.NPI 1801884879
Title
Optometrist /Owner
Phone
(205) 932-5286

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X S449TA072 AL Primary

Addresses

Primary practice location

124 16TH St NE
Fayette, AL 35555-1340

Mailing address

124 16TH St NE
Fayette, AL 35555-1340
Phone (205) 932-5286

National Provider Directory

National Provider Directory

Locations

124 16th St NE
Fayette, AL 35555
Phone (205) 932-5286

Practitioners & affiliated clinicians

Practitioners 1

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": "1205193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205366400000",
    "number": "1114197720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 16TH ST NE",
            "city": "FAYETTE",
            "state": "AL",
            "postal_code": "355551340",
            "telephone_number": "205-932-5286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 16TH ST NE",
            "city": "FAYETTE",
            "state": "AL",
            "postal_code": "355551340",
            "telephone_number": "205-932-5286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. BRUCE A. PERRY OD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-11",
        "last_updated": "2008-03-13",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OPTOMETRIST /OWNER",
        "authorized_official_telephone_number": "205-932-5286",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AL",
            "license": "S449TA072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayette, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.