Brad Moriarty OD PC

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

T484 Issued in SD

Legal business name

BRAD MORIARTY OD PC

Practice address

1601 Mount Rushmore Rd
Suite 5
Rapid City, SD 57701-4588

Phone

(605) 343-4164

Fax

(605) 348-9773

NPI assigned

Oct 26, 2010

Last updated

Apr 27, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Brad Jerome Moriarty, OD

Title

President

Phone

(605) 343-4164

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 3

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.

• Elizabeth Ann Ellender, O.D.

  • Optometrist
  • Rapid City, SD
  • NPI 1417028051
  NPD (past)
• Michael Scott Ellender, O.D.

  • Optometrist
  • Rapid City, SD
  • NPI 1245301787
  NPD (past)
• Cary S. Feldman

  • Optometrist
  • Rapid City, SD
  • NPI 1073735759
  NPD (past)

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

{
    "created_epoch": "1288051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335484800000",
    "number": "1225338148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 MOUNT RUSHMORE RD",
            "address_2": "SUITE 5",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577014588",
            "telephone_number": "605-343-4164",
            "fax_number": "605-348-9773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 MOUNT RUSHMORE RD",
            "address_2": "SUITE 5",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577014588",
            "telephone_number": "605-343-4164",
            "fax_number": "605-348-9773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAD MORIARTY OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-26",
        "last_updated": "2012-04-27",
        "status": "A",
        "authorized_official_last_name": "MORIARTY",
        "authorized_official_first_name": "BRAD",
        "authorized_official_middle_name": "JEROME",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "605-343-4164",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "SD",
            "license": "T484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "S104430",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9202310",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Ann Boyd
• Stacey Boyd, LPN
• Tiara Jean Boyer, MATRG
• Diana Boyle, MS,LPC,NCC,CEAP,LAC
• Kathleen A Boyle, OT
• Brent J. Bradley, D.D.S
• Heather R Bradley, MS CCC-SLP
• Kierstin Elizabeth Bradley
• Shari Lynn Bradstream, CCDC III
• Danielle Rose Brady, NCC, LPC

• Corneal and Contact Management Optometrist in Rapid City, SD
• Providers in Rapid City, SD by specialty
• Corneal and Contact Management Optometrist in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2012; 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.