Individual provider Active NPI

Thomas Dean Brown, OD

  • Optometrist
  • Fremont, NE
National Provider Identifier
1356344774
Registry record updated Jan 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1019 Issued in NE
Practice address
2827 N Clarkson St
Fremont, NE 68025-7714
Phone
(402) 721-7222
Fax
(402) 721-2473
NPI assigned
May 31, 2005
Last updated
Jan 28, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1019 NE Primary

Addresses

Primary practice location

2827 N Clarkson St
Fremont, NE 68025-7714

Mailing address

2827 N Clarkson St
Fremont, NE 68025-7714
Phone (402) 721-7222

Other identifiers 1

IdentifierTypeStateIssuer
47066963702MedicaidNE

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201478400000",
    "number": "1356344774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2827 N CLARKSON ST",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680257714",
            "telephone_number": "402-721-7222",
            "fax_number": "402-721-2473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2827 N CLARKSON ST",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680257714",
            "telephone_number": "402-721-7222",
            "fax_number": "402-721-2473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "THOMAS",
        "middle_name": "DEAN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2008-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NE",
            "license": "1019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47066963702",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.