Individual provider Active NPI

Brittany B. Boyette, O.D.

  • Optometrist
  • Sherwood, AR
National Provider Identifier
1669670063
Registry record updated Nov 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2586 Issued in AR
Practice address
305 E Kiehl Ave
Sherwood, AR 72120-2921
Phone
(501) 835-3937
Fax
(501) 835-2040
NPI assigned
Jul 6, 2007
Last updated
Nov 6, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2586 AR Primary

Addresses

Primary practice location

305 E Kiehl Ave
Sherwood, AR 72120-2921

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899

Other identifiers 4

IdentifierTypeStateIssuer
166521722MedicaidAR
49997OtherARAR BLUECROSS BLUE SHIELD
49997B171OtherARAR BLUECROSS BLUE SHIELD
49997F895OtherARAR BLUECROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20071129000405 AR Practitioner - Optometry 5193814069 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Med Southwest PLLCGroup PAC ID 4082952874, 234 clinicians

Practice addresses (Care Compare)

305 E Kiehl Ave
Sherwood, AR 72120-2921
Phone (501) 835-3937

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery25

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2586ARMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Med Southwest, PLLC Optometrist CurrentSince Nov 16, 2020 Accepting new patients
Med Southwest, PLLC Optometrist Current Accepting new patients
Ronald a Burks OD PA Optometrist CurrentSince Feb 19, 1992 Accepting new patients
Med Southwest, PLLC Optometrist CurrentSince Nov 16, 2020 Accepting new patients
Robert Lyon Berry M.D. Optometrist Past Accepting new patients
Silver Spring Optometry, LLC Optometrist Past Accepting new patients
George Schroeder, M.D., P.a. PastSince Jan 7, 2009 Accepting new patients

Locations

1300 N Center St
Ste A
Lonoke, AR 72086
Phone (501) 676-5100

305 E Kiehl Ave
Sherwood, AR 72120
Phone (501) 753-1237

114 E 49th St
Texarkana, AR 71854
Phone (870) 774-2020

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1183680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604620800000",
    "number": "1669670063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 E KIEHL AVE",
            "city": "SHERWOOD",
            "state": "AR",
            "postal_code": "721202921",
            "telephone_number": "501-835-3937",
            "fax_number": "501-835-2040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYETTE",
        "first_name": "BRITTANY",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-06",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "166521722",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AR BLUECROSS BLUE SHIELD",
            "identifier": "49997",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AR BLUECROSS BLUE SHIELD",
            "identifier": "49997B171",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AR BLUECROSS BLUE SHIELD",
            "identifier": "49997F895",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherwood, AR

Sources for this page

Verify at the official NPI Registry.