Individual provider Active NPI

Amanda Brewer-Lord, O.D.

  • Optometrist
  • Wytheville, VA
National Provider Identifier
1679560254
Registry record updated Apr 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618000743 Issued in VA
Practice address
530 W Ridge Rd
Suite B
Wytheville, VA 24382-1042
Phone
(276) 223-0033
Fax
(276) 223-0327
NPI assigned
Sep 29, 2005
Last updated
Apr 19, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618000743 VA Primary

Addresses

Primary practice location

530 W Ridge Rd
Suite B
Wytheville, VA 24382-1042

Mailing address

530 W Ridge Rd
Suite B
Wytheville, VA 24382-1188
Phone (276) 223-0033

Other identifiers 1

IdentifierTypeStateIssuer
010298458MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20100322000572 VA Practitioner - Optometry 4688623416 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1997
Medicare assignment
May accept Medicare assignment
Group practices
Wythe Eye Associates Amanda Brewer-Smith OD IncGroup PAC ID 1153370531, 5 clinicians

Practice addresses (Care Compare)

530 W Ridge Rd
Wytheville, VA 24382-1848
Phone (276) 223-0033

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
18.33 of 100Reported as individual
Quality
36.67
Improvement activities
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0618000743VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Wythe Eye Associates Amanda Brewer-Smith OD Inc Optometrist CurrentSince Jun 1, 1998 Accepting new patients
Blue Ridge Eye Care, Inc. Optometrist PastSince Nov 29, 2001 Accepting new patients

Locations

14 Westwood Medical Park
Bluefield, VA 24605
Phone (276) 322-7335

952 E Stuart Dr
Galax, VA 24333
Phone (276) 236-4673

1510 Bob White Blvd
Pulaski, VA 24301
Phone (540) 980-1965

334 N Washington Ave
Pulaski, VA 24301
Phone (540) 980-5890

530 W Ridge Rd
Wytheville, VA 24382
Phone (276) 223-0033

530 W Ridge Rd
Ste B
Wytheville, VA 24382
Phone (276) 223-0033

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334793600000",
    "number": "1679560254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 W RIDGE RD",
            "address_2": "SUITE B",
            "city": "WYTHEVILLE",
            "state": "VA",
            "postal_code": "243821188",
            "telephone_number": "276-223-0033",
            "fax_number": "276-223-0327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 W RIDGE RD",
            "address_2": "SUITE B",
            "city": "WYTHEVILLE",
            "state": "VA",
            "postal_code": "243821042",
            "telephone_number": "276-223-0033",
            "fax_number": "276-223-0327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREWER-LORD",
        "first_name": "AMANDA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-29",
        "last_updated": "2012-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618000743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010298458",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wytheville, VA

Sources for this page

Verify at the official NPI Registry.