James Edward Brown, O D – Optometrist in Bruce, MS

Key facts

NPI: 1447364005
Entity type: Individual (NPI type 1)
Primary specialty: Optometrist 152W00000X
License: 577 (MS)
Practice address: 208 W Calhoun St
Bruce, MS 38915-0988
Phone: (662) 983-2323
Fax: (662) 983-4126
NPI assigned: Aug 19, 2006
Sex: Male
Sole proprietor: Yes

Organizations & group practices 2

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.

Bruce Eye Clinic, Inc Optometrist · Bruce, MS · NPI 1447456876

Medicare reassignment Care Compare group NPD Authorized official MS · OPTOMETRIST
Bruce Eye Clinic Inc. Durable Medical Equipment & Medical Supplies · Bruce, MS · NPI 1902819188

NPD

Medicare Care Compare profile

Specialty: Optometry
Education: Southern College of Optometry, 1991
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Group practices: Bruce Eye Clinic Inc. (2 clinicians)

Practice addresses (Care Compare)

208 W Calhoun St
Bruce, MS 38915-9370
Phone (662) 983-2323

Procedures performed for Medicare patients

Procedure	Number of procedures
Cataract surgery	35

Medicare participation

Medicare fee-for-service enrollment: Enrolled in MS
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20070716000108	MS	Practitioner - Optometry	5395845614	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes

Practice roles

Organization	Specialty	Status	New patients
Bruce Eye Clinic, Inc	Optometrist	Current since May 21, 2006	Accepting new patients
Bruce Eye Clinic Inc.		Current since Feb 1, 1992	Accepting new patients

Locations

208 W Calhoun St
Bruce, MS 38915
Phone (662) 983-2323

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Optometrist	152W00000X	577	MS	Yes

Addresses

Primary practice location

208 W Calhoun St
Bruce, MS 38915-0988

Mailing address

PO Box 988
208 W Calhoun
Bruce, MS 38915-0988
Phone (662) 983-2323

Other identifiers

Identifier	Type	State	Issuer
00880002	Medicaid	MS

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447364005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 988",
            "address_2": "208 W CALHOUN",
            "city": "BRUCE",
            "state": "MS",
            "postal_code": "389150988",
            "telephone_number": "662-983-2323",
            "fax_number": "662-983-4126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 W CALHOUN ST",
            "city": "BRUCE",
            "state": "MS",
            "postal_code": "389150988",
            "telephone_number": "662-983-2323",
            "fax_number": "662-983-4126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JAMES",
        "middle_name": "EDWARD",
        "credential": "O D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00880002",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bruce, MS

All providers in Bruce, MS · Optometrist in Mississippi

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
Medicare Care Compare provider data (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.