Organization Active NPI

Bruce Eye Clinic, Inc

  • Optometrist
  • Bruce, MS
National Provider Identifier
1447456876
Registry record updated Mar 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
577 Issued in MS
Legal business name
BRUCE EYE CLINIC, INC
Practice address
208 W. Calhoun St
Bruce, MS 38915-0988
Phone
(662) 983-2323
Fax
(662) 983-4126
NPI assigned
Jun 22, 2007
Last updated
Mar 6, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2008

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

Authorized official

Name
James Edward Brown, ODNPI 1447364005
Title
Owner
Phone
(662) 983-2323

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X 577 MS
Optometrist 152W00000X 577 MS Primary

Addresses

Primary practice location

208 W. Calhoun St
Bruce, MS 38915-0988

Mailing address

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070716000111 MS Part B Supplier - Clinic/Group Practice 8022118348 Receives reassigned benefits from 2 practitioners
Practice locations: Grenada, MS; Bruce, MS

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
25D2066999Bruce Eye Clinic, Inc208 W Calhoun Street, Bruce, MS 38915Certificate of waiverOct 6, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1182470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204761600000",
    "number": "1447456876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 988",
            "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": {
        "organization_name": "BRUCE EYE CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-22",
        "last_updated": "2008-03-06",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-983-2323",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "MS",
            "license": "577",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bruce, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.