Individual provider Active NPI

Marty Chadwick Brewer, O.D.

  • Corneal and Contact Management Optometrist
  • Florence, AL
National Provider Identifier
1508973264
Registry record updated Mar 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
S-A64-TA-625 Issued in AL
Practice address
711 Cox Creek Pkwy
Florence, AL 35630-1001
Phone
(256) 766-3139
Fax
(256) 760-1849
NPI assigned
Aug 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X S-A64-TA-625 AL Primary

Addresses

Primary practice location

711 Cox Creek Pkwy
Florence, AL 35630-1001

Mailing address

711 Cox Creek Pkwy
Florence, AL 35630-1001
Phone (256) 766-3139

Other identifiers 1

IdentifierTypeStateIssuer
051554085MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20070814000465 AL Practitioner - Optometry 1153218532 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florence Eye Center, Inc.Group PAC ID 4082631874, 4 clinicians

Practice addresses (Care Compare)

506 N Main
Florence, AL 35630
Phone (256) 383-2121

711 Cox Creek Pkwy
Florence, AL 35630-1001
Phone (256) 766-3139

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery60

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S-A64-TA-625ALMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Florence Eye Center, Inc. CurrentSince May 27, 2009 Accepting new patients
Florence Eye Center, Inc. Current Accepting new patients
Florence Eye Center, Inc Past Accepting new patients
Chad Brewer, OD PC PastSince Jul 1, 2003 Accepting new patients

Locations

711 Cox Creek Pkwy
Florence, AL 35630
Phone (256) 383-2121

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267401600000",
    "number": "1508973264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 COX CREEK PKWY",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356301001",
            "telephone_number": "256-766-3139",
            "fax_number": "256-760-1849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 COX CREEK PKWY",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356301001",
            "telephone_number": "256-766-3139",
            "fax_number": "256-760-1849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREWER",
        "first_name": "MARTY",
        "middle_name": "CHADWICK",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2010-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "AL",
            "license": "S-A64-TA-625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051554085",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, AL

Sources for this page

Verify at the official NPI Registry.