Active NPI
Daniel J Brothers, O.D.
- Optometrist
- Joplin, MO
National Provider Identifier
1851396279
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- T02388
- Practice address
- 2013 S Joplin Ave
Joplin, MO 64804-2033 - Phone
- (417) 624-5005
- Fax
- (417) 624-5215
- NPI assigned
- Jun 14, 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 | T02388 | MO | Primary |
Addresses
Primary practice location
2013 S Joplin Ave
Joplin, MO 64804-2033
Mailing address
4517 Belmont Dr
Joplin, MO 64804-5247
Phone (417) 782-1911
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 32592 | Other | MO | BCBS |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T02388 | MO | MD | Optometrist |
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": "1118707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200528000000",
"number": "1851396279",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4517 BELMONT DR",
"city": "JOPLIN",
"state": "MO",
"postal_code": "648045247",
"telephone_number": "417-782-1911"
},
{
"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": "DANIEL",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-14",
"last_updated": "2008-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MO",
"license": "T02388",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "32592",
"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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.