Organization Active NPI

Steven D. Bravard, O.D., P.a.

  • Optometrist
  • Little Rock, AR
National Provider Identifier
1780975367
Registry record updated Apr 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2397 Issued in AR
Legal business name
STEVEN D. BRAVARD, O.D., P.A.
Practice address
2700 S Shackleford Rd
Little Rock, AR 72205-6918
Phone
(501) 228-3937
Fax
(501) 225-4576
NPI assigned
Apr 29, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2011

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

Authorized official

Name
Dr. Steven Douglas Bravard, O.D.
Title
President
Phone
(501) 228-3937

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 2397 AR Primary

Addresses

Primary practice location

2700 S Shackleford Rd
Little Rock, AR 72205-6918

Mailing address

2700 S Shackleford Rd
Little Rock, AR 72205-6918
Phone (501) 228-3937

Other identifiers 1

IdentifierTypeStateIssuer
120862722MedicaidAR

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1304035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304035200000",
    "number": "1780975367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 S SHACKLEFORD RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056918",
            "telephone_number": "501-228-3937",
            "fax_number": "501-225-4576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 S SHACKLEFORD RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056918",
            "telephone_number": "501-228-3937",
            "fax_number": "501-225-4576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVEN D. BRAVARD, O.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-29",
        "last_updated": "2011-04-29",
        "status": "A",
        "authorized_official_last_name": "BRAVARD",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "501-228-3937",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120862722",
            "state": "AR"
        }
    ],
    "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 Apr 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.