Active NPI
Larry J Brothers, O.D.
- Optometrist
- Joplin, MO
National Provider Identifier
1740287952
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- T02605
- Practice address
- 2013 S Joplin Ave
Joplin, MO 64804-2033 - Phone
- (417) 624-5005
- Fax
- (417) 624-5215
- NPI assigned
- Jul 1, 2005
- Last updated
- Jan 17, 2008
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | T02605 | MO | Primary |
Addresses
Primary practice location
2013 S Joplin Ave
Joplin, MO 64804-2033
Mailing address
4777 Seagraves Dr
Joplin, MO 64804-5550
Phone (417) 782-1133
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 32594 | Other | MO | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- University of Missouri St Louis - School of Optometry, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2013 S Joplin Ave
Joplin, MO 64804-2033
Phone (417) 624-5005
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 28 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T02605 | MO | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brothers Taylor & Bezold Inc | Optometrist | Current | Accepting new patients |
Locations
2013 S Joplin Ave
Joplin, MO 64804
Phone (417) 624-5005
Organizations & group practices 1
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": "1120176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200528000000",
"number": "1740287952",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4777 SEAGRAVES DR",
"city": "JOPLIN",
"state": "MO",
"postal_code": "648045550",
"telephone_number": "417-782-1133"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2013 S JOPLIN AVE",
"city": "JOPLIN",
"state": "MO",
"postal_code": "648042033",
"telephone_number": "417-624-5005",
"fax_number": "417-624-5215"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROTHERS",
"first_name": "LARRY",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-01",
"last_updated": "2008-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MO",
"license": "T02605",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "32594",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Joplin, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2008; 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.