PBW Optometry P C

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

AZ178 Issued in AZ

Legal business name

PBW OPTOMETRY P C

Practice address

2215 Hualapai Mountain Rd
Kingman, AZ 86401-8324

Phone

(928) 718-1009

NPI assigned

Feb 28, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Lawrence A Pearl, O D

Title

President

Phone

(602) 524-7618

Specialties & licenses 1

Addresses

Other names 1

• RIVERVIEW VISION AND LASER CENTER Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Richard Bullen, OD

  • Optometrist
  • Kingman, AZ
  • NPI 1811565252
  Medicare reassignment NPD
• Rhett Melvin Burgener, OD

  • Optometrist
  • Lake Havasu City, AZ
  • NPI 1598712440
  Medicare reassignment NPD
• Jordan Evans, OD

  • Optometrist
  • Redding, CA
  • NPI 1225680853

  AZ

  Medicare reassignment NPD

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255468930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 HUALAPAI MOUNTAIN RD",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864018324",
            "telephone_number": "928-718-1009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 HUALAPAI MOUNTAIN RD",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864018324",
            "telephone_number": "928-718-1009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PBW OPTOMETRY P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PEARL",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "602-524-7618",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O D"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "AZ",
            "license": "AZ178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RIVERVIEW VISION AND LASER CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Akrutiben Jinkal Patel, DO
• Mansi Patel, MD
• Nikunj Patel, MPHARM
• Christen Paul, M.D
• Jocelyn Pawlicki, FNP
• Micah Ashley Pearson-Sealy, LMSW
• Tahra Elizabeth Pearson, RN
• Carol Pease, MS, CPC
• Brandon Arne Pedersen, DO
• Bradley Mychel Pelham, DDS

• Corneal and Contact Management Optometrist in Kingman, AZ
• Providers in Kingman, AZ by specialty
• Corneal and Contact Management Optometrist in Arizona

• 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.
• 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.