Organization Active NPI

Richard E. Braley, M.D. P.a.

  • Ophthalmology Physician
  • Hot Springs National Park, AR
National Provider Identifier
1659608669
Registry record updated Oct 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
R2711 Issued in AR
Legal business name
RICHARD E. BRALEY, M.D. P.A.
Practice address
1661 Higdon Ferry Rd
Hot Springs National Park, AR 71913-6913
Phone
(501) 525-0790
Fax
(501) 525-9989
NPI assigned
Nov 11, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2013

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

Authorized official

Name
Dr. Richard E Braley, M.D.NPI 1467486753
Title
President
Phone
(501) 525-0790

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X R2711 AR Primary

Addresses

Primary practice location

1661 Higdon Ferry Rd
Hot Springs National Park, AR 71913-6913

Mailing address

1661 Higdon Ferry Rd
Hot Springs National Park, AR 71913-6913
Phone (501) 525-0790

Other identifiers 2

IdentifierTypeStateIssuer
1314100040OtherARQUALCHOICE
102433001MedicaidAR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091219000033 AR Part B Supplier - Clinic/Group Practice 3971643164 Receives reassigned benefits from 1 practitioner
Practice locations: Hot Springs National Park, AR

National Provider Directory

National Provider Directory

Locations

1661 Higdon Ferry Rd
Hot Springs National Park, AR 71913
Phone (501) 525-0790

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1257897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381449600000",
    "number": "1659608669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1661 HIGDON FERRY RD",
            "city": "HOT SPRINGS NATIONAL PARK",
            "state": "AR",
            "postal_code": "719136913",
            "telephone_number": "501-525-0790",
            "fax_number": "501-525-9989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1661 HIGDON FERRY RD",
            "city": "HOT SPRINGS NATIONAL PARK",
            "state": "AR",
            "postal_code": "719136913",
            "telephone_number": "501-525-0790",
            "fax_number": "501-525-9989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD E. BRALEY, M.D. P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-11",
        "last_updated": "2013-10-11",
        "status": "A",
        "authorized_official_last_name": "BRALEY",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "501-525-0790",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "AR",
            "license": "R2711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCHOICE",
            "identifier": "1314100040",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102433001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hot Springs National Park, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.