Derek S Long OD Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

2547 Issued in AR

Legal business name

DEREK S LONG OD INC

Doing business as

North Little Rock Primary Eye Care

Practice address

406 W Pershing Blvd
North Little Rock, AR 72114-2146

Phone

(501) 753-3145

Fax

(501) 753-1806

NPI assigned

Dec 17, 2008

Last updated

May 31, 2011By 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

Derek S Long, O.D.NPI 1699734368

Title

Doctor

Phone

(501) 803-3937

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• North Little Rock Primary Eye Care Doing business as

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Derek S Long OD Inc

  dba Eye Exams, Inc

  • Optometrist
  • Hot Springs, AR
  • NPI 1487812392

  O20090511000536

  Same enrollment
• Derek S Long OD, Inc

  dba Maumelle Eye Care

  • Optometrist
  • Maumelle, AR
  • NPI 1043412067

  O20090511000536

  Same enrollment

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.

• Derek Scott Long, O.D.

  • Optometrist
  • Maumelle, AR
  • NPI 1699734368
  Medicare reassignment Care Compare group Authorized official
• Edward Lee McDonnell, O.D.

  • Optometrist
  • Magnolia, AR
  • NPI 1770542508
  Medicare reassignment Care Compare group NPD
• Andrea Walker

  • Optometrist
  • Maumelle, AR
  • NPI 1780067587
  Medicare reassignment NPD

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

{
    "created_epoch": "1229472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306800000000",
    "number": "1255577532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 W PERSHING BLVD",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721142146",
            "telephone_number": "501-753-3145",
            "fax_number": "501-753-1806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 W PERSHING BLVD",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721142146",
            "telephone_number": "501-753-3145",
            "fax_number": "501-753-1806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEREK S LONG OD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-17",
        "last_updated": "2011-05-31",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "DEREK",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "501-803-3937",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1487812392",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Little Rock Primary Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carol Ann Denham, OTR/L
• Christopher Brian Denham, RKT
• Megan Denhard
• Jeremy Dennis
• Dental Health Center of Arkansas, P.a.
• Christopher Mario Deri, MD
• Dermlogic, P.L.L.C, PA
• Lauren Derr
• Freya Desai
• Robert Matthew Desalvo

• 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 May 31, 2011; 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.