Brett P Richardson OD PLLC
Organization Active NPI Optometrist · Mesquite, NV
NPI 1235540998 · NPPES record last updated Nov 11, 2020
Key facts
- NPI
- 1235540998
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- 918 (NV)
- Legal business name
- BRETT P RICHARDSON OD PLLC
- Practice address
- 1120 W Pioneer Blvd
Mesquite, NV 89027 - Phone
- (360) 991-9548
- NPI assigned
- May 15, 2014
- Organization subpart
- No
Authorized official
- Name
- Dr. Brett P Richardson, OD
- Title
- Owner
- Phone
- (360) 991-9548
Practitioners 3
-
Brett Richardson, O.D.
-
Robert Gilbert, O.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180914001496 | UT | Part B Supplier - Clinic/Group Practice | 1850615287 |
Receives reassigned benefits from 1 practitioner Practice locations: Washington, UT |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | 918 | NV | Yes |
Addresses
Primary practice location
1120 W Pioneer Blvd
Mesquite, NV 89027
Mailing address
31 W Brookhaven Dr
Washington, UT 84780-5004
Phone (360) 991-9548
Other practice location 1
625 W Telegraph St
Washington, UT 84780-1541
Phone (435) 986-3770
Other providers in Mesquite, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 11, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.