Active NPI
Harold Bernard Brewer Jr., A.B.O.C.
- Optician
- Brandon, MS
National Provider Identifier
1659612836
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- Practice address
- 1171 Johns Mayton Rd
Brandon, MS 39042-8364 - Phone
- (601) 519-8209
- NPI assigned
- Mar 12, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | Primary |
Addresses
Primary practice location
1171 Johns Mayton Rd
Brandon, MS 39042-8364
Mailing address
PO Box 430
Brandon, MS 39043-0430
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 006574 | Other | MS | AMERICAN BOARD OF OPTICIANRY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1363046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1396483200000",
"number": "1659612836",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 430",
"city": "BRANDON",
"state": "MS",
"postal_code": "390430430"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1171 JOHNS MAYTON RD",
"city": "BRANDON",
"state": "MS",
"postal_code": "390428364",
"telephone_number": "601-519-8209"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BREWER",
"first_name": "HAROLD",
"middle_name": "BERNARD",
"name_suffix": "Jr.",
"credential": "A.B.O.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-03-12",
"last_updated": "2014-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAN BOARD OF OPTICIANRY",
"identifier": "006574",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brandon, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.