Kenneth W. Brawner, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODT690 Issued in TN

Practice address

900 Conference Dr
Suite 15-B
Goodlettsville, TN 37072-1909

Phone

(615) 859-1912

Fax

(615) 859-1965

NPI assigned

Aug 17, 2005

Last updated

Mar 22, 2012By the provider in NPPES

Sex

Male

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

Medicare fee-for-service enrollment

Enrolled in TN

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

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.

• The Eye Clinic of Goodlettsville, PC

  • Optometrist
  • Goodlettsville, TN
  • NPI 1730750696
  NPD (past)

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

{
    "created_epoch": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332374400000",
    "number": "1477545341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 CONFERENCE DR",
            "address_2": "SUITE 15-B",
            "city": "GOODLETTSVILLE",
            "state": "TN",
            "postal_code": "370721909",
            "telephone_number": "615-859-1912",
            "fax_number": "615-859-1965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 CONFERENCE DR",
            "address_2": "SUITE 15-B",
            "city": "GOODLETTSVILLE",
            "state": "TN",
            "postal_code": "370721909",
            "telephone_number": "615-859-1912",
            "fax_number": "615-859-1965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAWNER",
        "first_name": "KENNETH",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-17",
        "last_updated": "2012-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "ODT690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3594517",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Boyd Jr., DPM
• Susan Bracey, FNP, MSN, BSN
• Katie Elizabeth Bradford, DDS
• Michelle L. Bradshaw, D.C.
• John Matthew Bratcher, CRNA
• Quintina Brewer, ME.D
• Kerry Wade Brito, RN
• Tomasa Rosanna Brito
• Michael Dorwin Broadnax II, TLMFT
• Brookdale Senior Living Communities, Inc. (Brookdale Goodlettsville)

• Optometrist in Goodlettsville, TN
• Providers in Goodlettsville, TN by specialty
• Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2012; 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.