Organization Active NPI

Dr James T Brom PSC

  • Optometrist
  • Flatwoods, KY
National Provider Identifier
1326211103
Registry record updated Feb 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0927DT Issued in KY
Legal business name
DR JAMES T BROM PSC
Practice address
2135 Argillite Rd Ste J
Flatwoods, KY 41139-1629
Phone
(606) 836-8153
Fax
(606) 834-9420
NPI assigned
Apr 11, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2014

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

Authorized official

Name
Linda Harbison
Title
Office Manager
Phone
(606) 836-8153

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 0927DT KY Primary

Addresses

Primary practice location

2135 Argillite Rd Ste J
Flatwoods, KY 41139-1629

Mailing address

PO Box 963
Flatwoods, KY 41139-0963
Phone (606) 836-8153

Other identifiers 2

IdentifierTypeStateIssuer
000000050261OtherKYBLUE CROSS BLUE SHIELD
77009272MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20081216000098 KY Part B Supplier - Clinic/Group Practice 6800958497 Receives reassigned benefits from 1 practitioner
Practice locations: Flatwoods, KY
O20100930095454 KY DME Supplier - Physician - Optometrist 6800958497 Practice locations: Flatwoods, KY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Dr. James T. Brom, P.S.C.2135 Argillite Rd, Flatwoods, KY 41139-1629(606) 836-8153 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jul 1, 1993

National Provider Directory

National Provider Directory

Locations

2135 Argillite Rd
Ste J
Flatwoods, KY 41139
Phone (606) 836-8153

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1207872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392940800000",
    "number": "1326211103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 963",
            "city": "FLATWOODS",
            "state": "KY",
            "postal_code": "411390963",
            "telephone_number": "606-836-8153",
            "fax_number": "606-834-9420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2135 ARGILLITE RD STE J",
            "city": "FLATWOODS",
            "state": "KY",
            "postal_code": "411391629",
            "telephone_number": "606-836-8153",
            "fax_number": "606-834-9420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR JAMES T BROM PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-11",
        "last_updated": "2014-02-21",
        "status": "A",
        "authorized_official_last_name": "HARBISON",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "606-836-8153"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "KY",
            "license": "0927DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000000050261",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77009272",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flatwoods, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.