Individual provider Active NPI

Bary M Brown, O.D.

  • Optometrist
  • Springfield, MO
National Provider Identifier
1386630580
Registry record updated Jun 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T02279 Issued in MO
Practice address
1441 E Sunshine St
Springfield, MO 65804-1211
Phone
(417) 886-2020
Fax
(417) 886-9875
NPI assigned
Sep 22, 2005
Last updated
Jun 14, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X T02279 MO Primary

Addresses

Primary practice location

1441 E Sunshine St
Springfield, MO 65804-1211

Mailing address

1441 E Sunshine St
Springfield, MO 65804-1211
Phone (417) 886-2020

Other identifiers 3

IdentifierTypeStateIssuer
0435010001OtherMODMERC REGION D
310817804MedicaidMO
410011386OtherMORAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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

Enrollment IDStateProvider typePAC IDDetails
I20100929000268 MO Practitioner - Optometry 7517081144 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
T02279MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
William R Chism OD PC Optometrist Past Accepting new patients
Ozark Eye Clinic, LLC Optometrist PastSince Jan 1, 2010 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308009600000",
    "number": "1386630580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 E SUNSHINE ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658041211",
            "telephone_number": "417-886-2020",
            "fax_number": "417-886-9875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 E SUNSHINE ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658041211",
            "telephone_number": "417-886-2020",
            "fax_number": "417-886-9875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "BARY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-22",
        "last_updated": "2011-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T02279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC REGION D",
            "identifier": "0435010001",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "310817804",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410011386",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.