Organization Active NPI

Van M Dunn

  • Optometrist
  • De Witt, AR
National Provider Identifier
1366432551
Registry record updated Jun 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
D12262 Issued in AR
Legal business name
VAN M DUNN
Practice address
1703 S Whitehead Dr
De Witt, AR 72042-2911
Phone
(870) 946-1716
Fax
(870) 946-1561
NPI assigned
Oct 27, 2005
Last updated
Jun 9, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2008

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

Authorized official

Name
Mrs. Sue F Currie
Title
Office Manager
Phone
(870) 946-1716

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X D12262 AR Primary

Addresses

Primary practice location

1703 S Whitehead Dr
De Witt, AR 72042-2911

Mailing address

PO Box 294
De Witt, AR 72042-0294
Phone (870) 946-1716

Other identifiers 1

IdentifierTypeStateIssuer
100926722MedicaidAR

National Provider Directory

National Provider Directory

Locations

609 W 13th St
Dewitt, AR 72042
Phone (870) 946-1120

129 W Waterman St
Dumas, AR 71639
Phone (870) 382-2394

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212969600000",
    "number": "1366432551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 294",
            "city": "DE WITT",
            "state": "AR",
            "postal_code": "720420294",
            "telephone_number": "870-946-1716",
            "fax_number": "870-946-1561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 S WHITEHEAD DR",
            "city": "DE WITT",
            "state": "AR",
            "postal_code": "720422911",
            "telephone_number": "870-946-1716",
            "fax_number": "870-946-1561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAN M DUNN",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-27",
        "last_updated": "2008-06-09",
        "status": "A",
        "authorized_official_last_name": "CURRIE",
        "authorized_official_first_name": "SUE",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "870-946-1716",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "D12262",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100926722",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in De Witt, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.