Brunswick Royalton Wong, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

452 Issued in MS

Practice address

411 Fairview Ave
Greenville, MS 38701-4816

Phone

(662) 332-7229

Fax

(662) 378-3949

NPI assigned

Oct 3, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern College of Optometry, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202169600000",
    "number": "1376637405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 FAIRVIEW AVE",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387014816",
            "telephone_number": "662-332-7229",
            "fax_number": "662-378-3949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 FAIRVIEW AVE",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387014816",
            "telephone_number": "662-332-7229",
            "fax_number": "662-378-3949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "BRUNSWICK",
        "middle_name": "ROYALTON",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2008-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09539294",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Octavia Rochelle Winder, LPC
• Mandy H Windham, FNP-BC
• Eustace Harold Winn III, DMD
• Caldwell E Winston Jr., MS CMHT
• Women & Pediatric Clinic
• Pamela C. Woods, CNA
• Tomeka Wright-Little, NURSE PRACTITIONER
• Christina Wright
• Denise Wright, CNP
• Wynn Sanders Pharmacy, Inc.

• All providers in Greenville, MS
• Optometrist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.