Active NPI
Kindra Brock, ABOC, LICENSED OPTIC
- Optician
- Little Rock, AR
National Provider Identifier
1760808752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- A-120802
- Practice address
- 5507 Ranch Dr
Suite 207
Little Rock, AR 72223-4538 - Phone
- (501) 200-7442
- NPI assigned
- Mar 14, 2014
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Optician | 156FX1800X | A-120802 | AR | Primary |
Addresses
Primary practice location
5507 Ranch Dr
Suite 207
Little Rock, AR 72223-4538
Mailing address
5507 Ranch Dr
Suite 207
Little Rock, AR 72223-4538
Phone (501) 200-7442
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A-120802 | AR | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1394755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1394755200000",
"number": "1760808752",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5507 RANCH DR",
"address_2": "SUITE 207",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722234538",
"telephone_number": "501-200-7442"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5507 RANCH DR",
"address_2": "SUITE 207",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722234538",
"telephone_number": "501-200-7442"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROCK",
"first_name": "KINDRA",
"credential": "ABOC, LICENSED OPTIC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-03-14",
"last_updated": "2014-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "AR",
"license": "A-120802",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Little Rock, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.