Active NPI
Lavell Edward Brooks Sr., OPTICIAN
- Optician
- Union Springs, AL
National Provider Identifier
1295259828
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 6136761
- Practice address
- 234 N Prairie Street
Union Springs, AL 36089 - Phone
- (334) 324-6832
- NPI assigned
- Jul 25, 2017
- Last updated
- Jul 25, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 6136761 | AL | Primary |
Addresses
Primary practice location
234 N Prairie Street
Union Springs, AL 36089
Mailing address
3160 Bozeman Dr
Montgomery, AL 36108-3944
Phone (334) 324-6832
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6136761 | Medicaid | AL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6136761 | AL | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1500940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1500940800000",
"number": "1295259828",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3160 BOZEMAN DR",
"city": "MONTGOMERY",
"state": "AL",
"postal_code": "361083944",
"telephone_number": "334-324-6832"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "234 N PRAIRIE STREET",
"city": "UNION SPRINGS",
"state": "AL",
"postal_code": "36089",
"telephone_number": "334-324-6832"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROOKS",
"first_name": "LAVELL",
"middle_name": "EDWARD",
"name_prefix": "Mr.",
"name_suffix": "Sr.",
"credential": "OPTICIAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-07-25",
"last_updated": "2017-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "AL",
"license": "6136761",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6136761",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Union Springs, AL
- Affordable Eyewear USA LP (Affordable Eyewear USA)
- Alabama CVS Pharmacy, L.L.C. (CVS Pharmacy #04860)
- Pamela Babers
- Adrienne Biggers, LMT,LPN
- Sandra Brown
- Bullock County
- Bullock County Health Care Authority
- Bullock County Health Care Authority (Bullock County Rural Emergency Hospital)
- Bullock County Health Care Authority (Perfect Kids & Family Care Clinic)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.