Bruce William Pierson, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OEG000043 Issued in PA

Practice address

130 Pickering Street
Brookville, PA 15825-1242

Phone

(814) 849-4602

Fax

(814) 849-3633

NPI assigned

Jun 15, 2005

Reactivated

Mar 24, 2006

Last updated

Sep 10, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bruce W Pierson

  • Eyewear Supplier
  • Brookville, PA
  • NPI 1609033026
  Authorized official Same address or phone

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347235200000",
    "number": "1255336467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 PICKERING STREET",
            "city": "BROOKVILLE",
            "state": "PA",
            "postal_code": "158251242",
            "telephone_number": "814-849-4602",
            "fax_number": "814-849-3633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 PICKERING STREET",
            "city": "BROOKVILLE",
            "state": "PA",
            "postal_code": "158251242",
            "telephone_number": "814-849-4602",
            "fax_number": "814-849-3633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIERSON",
        "first_name": "BRUCE",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-15",
        "last_updated": "2012-09-10",
        "deactivation_date": "2006-03-17",
        "reactivation_date": "2006-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010041200001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tanis S Pendleton, MD,PHD
• Timothy Paul Pendleton, MD
• Penn Highlands Home Medical Equipment LLC (SMP Home Medical Brookville)
• Penn Traffic Co (Bilo Foods and Pharmacy 9201)
• Phoenix Rehabilitation and Health Services, Inc.
• Kristi Dawn Powell, RN
• Premier Counseling & Consulting
• Primary Care Associates of Western PA.
• Primary Care Associates of Western Pennsylvania PC
• Joseph M Prusakowski, D.O.

• Optometrist in Brookville, PA
• Providers in Brookville, PA by specialty
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.