Anna J Clark, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2855 Issued in CO

Practice address

4491 Bent Brothers Blvd.
Colorado City, CO 81019-9366

Phone

(719) 676-3937

Fax

(719) 676-4390

NPI assigned

Jul 20, 2011

Last updated

Dec 20, 2016By the provider in NPPES

Sex

Female

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

Other names 1

• Dr. Anna J O'Brien Former name

Medicare fee-for-service enrollment

Enrolled in CO

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rocky Mountain Eye Center Inc a Colorado Provider Network

  • Ophthalmology Physician
  • Pueblo, CO
  • NPI 1073567459

  Optometrist

  Medicare reassignment NPD
• Eye Love Care Inc

  • Optometrist
  • Colorado Springs, CO
  • NPI 1114525680
  NPD (past)
• Eye Love Care Inc

  • Optometrist
  • Colorado Springs, CO
  • NPI 1265031322
  NPD (past)
• Eye Love Care Inc

  • Optometrist
  • Colorado Springs, CO
  • NPI 1881256147
  NPD (past)

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

{
    "created_epoch": "1311120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482192000000",
    "number": "1376831693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19366",
            "city": "COLORADO CITY",
            "state": "CO",
            "postal_code": "810199366",
            "telephone_number": "719-676-3937",
            "fax_number": "719-676-4390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4491 BENT BROTHERS BLVD.",
            "city": "COLORADO CITY",
            "state": "CO",
            "postal_code": "810199366",
            "telephone_number": "719-676-3937",
            "fax_number": "719-676-4390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ANNA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-20",
        "last_updated": "2016-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00685232",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNA",
            "last_name": "O'BRIEN",
            "middle_name": "J",
            "prefix": "DR.",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• 3D Vision, Inc
• Alexander Adams, BC-HIS
• Thomas Adams, BC-HIS
• Sherri Lynne Barnard, NP
• Teresa Barnes, P.T.
• Pamela Lynn Cook, MA, LPC, NCC
• Digicare Hearing Solutions Inc.
• Greenhorn Health Services PCT
• Hygge Holistic Counseling Inc
• Maureen E Kelly, MD

• Optometrist in Colorado City, CO
• Providers in Colorado City, CO by specialty
• Optometrist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.