Brad Victor Nuttall, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2722 Issued in AZ

Practice address

18325 N Allied Way Ste 100
Phoenix, AZ 85054-3106

Phone

(602) 467-4966

Fax

(480) 419-5401

NPI assigned

Aug 14, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, AZ2 enrollments

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 2

Specialty

Optometry

Education

Southern California College of Optometry, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Millennium Vision IncGroup PAC ID 1658350236, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Millennium Vision Inc

  • Ophthalmology Physician
  • Phoenix, AZ
  • NPI 1184730251

  Optometrist

  Medicare reassignment Care Compare group NPD
• Anadarko Indian Health Center

  • Federal Public Health Clinic/Center
  • Anadarko, OK
  • NPI 1881637403

  TX

  Medicare reassignment NPD
• Carnegie Indian Health Center

  • Federal Public Health Clinic/Center
  • Carnegie, OK
  • NPI 1457459158

  TX

  Medicare reassignment NPD
• Lawton Indian Hospital

  • General Acute Care Hospital
  • Lawton, OK
  • NPI 1760489223

  TX

  Medicare reassignment NPD

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

{
    "created_epoch": "1502668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1699290478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18325 N ALLIED WAY STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850543106",
            "telephone_number": "602-467-4966",
            "fax_number": "480-419-5401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18325 N ALLIED WAY STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850543106",
            "telephone_number": "602-467-4966",
            "fax_number": "480-419-5401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUTTALL",
        "first_name": "BRAD",
        "middle_name": "VICTOR",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-14",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S-D88-TA-A81",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "3140",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "2722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theresa E Nussbaumer, ANP
• Nutrishare, LLC
• Nutrition Education Specialists LLC
• Nutrition Is Medicine LLC
• Nutrition With Sammie, LLC
• Nuvida Home Care LLC
• Nuvion Health LLC
• Nuvision Centers PLLC
• Nuvista Integrated Health LLC
• Serena Nuwar

• Optometrist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Optometrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.