Individual provider Active NPI

Brandon Corey Craine, OD

  • Optometrist
  • Manila, AR
National Provider Identifier
1285663583
Registry record updated Apr 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2521 Issued in AR
Practice address
Highway 18 Bypass
Manila, AR 72442
Phone
(870) 561-3224
Fax
(870) 561-4370
NPI assigned
Jul 1, 2006
Last updated
Apr 20, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2521 AR Primary

Addresses

Primary practice location

Highway 18 Bypass
Manila, AR 72442

Mailing address

623 E Matthews Ave
# A
Jonesboro, AR 72401-3145
Phone (870) 561-3224

Other identifiers 1

IdentifierTypeStateIssuer
143936722MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100726000406 AR Practitioner - Optometry 1759413834 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vision Care Center of Northeast Arkansas LLCGroup PAC ID 2860470374, 8 clinicians

Practice addresses (Care Compare)

623 E Matthews Ave
Suite a
Jonesboro, AR 72401-3145
Phone (870) 932-2211

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2521ARMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Care Center of Northeast Arkansas LLC Optometrist CurrentSince Sep 1, 2001 Accepting new patients

Locations

623 E Matthews Ave
Jonesboro, AR 72401
Phone (870) 536-4100

623 E Matthews Ave
Ste A
Jonesboro, AR 72401
Phone (870) 932-2211

4002 Linwood Dr
Paragould, AR 72450
Phone (870) 932-2211

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492646400000",
    "number": "1285663583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 E MATTHEWS AVE",
            "address_2": "# A",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013145",
            "telephone_number": "870-561-3224",
            "fax_number": "870-561-4370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HIGHWAY 18 BYPASS",
            "city": "MANILA",
            "state": "AR",
            "postal_code": "72442",
            "telephone_number": "870-561-3224",
            "fax_number": "870-561-4370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAINE",
        "first_name": "BRANDON",
        "middle_name": "COREY",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-01",
        "last_updated": "2017-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2521",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "143936722",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manila, AR

Sources for this page

Verify at the official NPI Registry.