Dr Penny Freshour OD PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

AR2483 Issued in AR

Legal business name

DR PENNY FRESHOUR OD PA

Practice address

3929 McCain Blvd
#G07A
North Little Rock, AR 72116-8011

Phone

(501) 791-0660

Fax

(501) 753-4401

NPI assigned

Jan 9, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Penny Freshour

Title

Owner

Phone

(501) 791-0660

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184773020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3929 MCCAIN BLVD",
            "address_2": "#G07A",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721168011",
            "telephone_number": "501-791-0660",
            "fax_number": "501-753-4401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3929 MCCAIN BLVD",
            "address_2": "#G07A",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721168011",
            "telephone_number": "501-791-0660",
            "fax_number": "501-753-4401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR PENNY FRESHOUR OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FRESHOUR",
        "authorized_official_first_name": "PENNY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-791-0660",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AR",
            "license": "AR2483",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCHOICE",
            "identifier": "19983000040",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AR LICENSE",
            "identifier": "AR2483",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00273197",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in North Little Rock, AR
• Providers in North Little Rock, AR by specialty
• Optometrist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.