NPIMap

Organization Active NPI

Little Rock Air Force Base Eye Care

  • Optometrist
  • Little Rock, AR
National Provider Identifier
1356876577
Registry record updated Apr 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
LITTLE ROCK AIR FORCE BASE EYE CARE
Practice address
6TH Street, BLDG 787
Little Rock Air Force Base
Little Rock, AR 72099
Phone
(501) 983-0106
Fax
(501) 983-0008
NPI assigned
Apr 25, 2017
Organization subpart
Yes
Parent organization
MAUMELLE EYE CAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 25, 2017

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

Authorized official

Name
Prof. Derek Scott Long, O.D.
Title
Owner
Phone
(501) 983-0106

Specialties & licenses 1

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

Addresses

Primary practice location

6TH Street, BLDG 787
Little Rock Air Force Base
Little Rock, AR 72099

Mailing address

6TH Street, BLDG 787
Little Rock Air Force Base
Little Rock, AR 72099
Phone (501) 983-0106

National Provider Directory

National Provider Directory
Tax ID family
Derek S Long OD Inc3 organizations share this tax ID, including this one
Part of
Derek S Long OD Inc

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6th St
Bldg 787
Little Rock Air Force Base, AR 72099
Phone (501) 983-0106

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1493078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493078400000",
    "number": "1356876577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6TH STREET, BLDG 787",
            "address_2": "LITTLE ROCK AIR FORCE BASE",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "72099",
            "telephone_number": "501-983-0106",
            "fax_number": "501-983-0008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6TH STREET, BLDG 787",
            "address_2": "LITTLE ROCK AIR FORCE BASE",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "72099",
            "telephone_number": "501-983-0106",
            "fax_number": "501-983-0008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITTLE ROCK AIR FORCE BASE EYE CARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MAUMELLE EYE CARE",
        "enumeration_date": "2017-04-25",
        "last_updated": "2017-04-25",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "DEREK",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-983-0106",
        "authorized_official_name_prefix": "Prof.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 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.

Verify at the official NPI Registry.