Daniel J Hennessey III, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2322 Issued in AR

Practice address

4200 N. Rodney Parham Road
Suite 101
Little Rock, AR 72212
UM

Phone

(501) 224-5658

Fax

(501) 687-0801

NPI assigned

Dec 13, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AR

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

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 and National Provider Directory roles.

• Little Rock Eye Clinic, LLP

  • Ophthalmology Physician
  • Little Rock, AR
  • NPI 1992764914

  Optometrist

  Medicare reassignment NPD

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571097600000",
    "number": "1427033596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 EXECUTIVE CT",
            "address_2": "SUITE A",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722054536",
            "telephone_number": "501-224-5658",
            "fax_number": "501-224-8114"
        },
        {
            "country_code": "UM",
            "country_name": "United States Minor Outlying Islands",
            "address_purpose": "LOCATION",
            "address_type": "FGN",
            "address_1": "4200 N. RODNEY PARHAM ROAD",
            "address_2": "SUITE 101",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "72212",
            "telephone_number": "501-224-5658",
            "fax_number": "501-687-0801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNESSEY",
        "first_name": "DANIEL",
        "middle_name": "J",
        "name_suffix": "III",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-13",
        "last_updated": "2019-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110756722",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID-TYPE UNSPECIFIED",
            "identifier": "48867",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2019; 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.