Active NPI
Brian Scott Duvall, OD
- Optometrist
- North Bend, WA
National Provider Identifier
1962446948
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 3256
- Practice address
- 126 E 2ND St
North Bend, WA 98045-9175 - Phone
- (425) 831-2020
- Fax
- (425) 831-0027
- NPI assigned
- Jun 16, 2006
- 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 | 3256 | WA | Primary |
Addresses
Primary practice location
126 E 2ND St
North Bend, WA 98045-9175
Mailing address
126 E 2ND St
North Bend, WA 98045-9175
Phone (425) 831-2020
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2025252 | Medicaid | WA |
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 |
|---|---|---|---|
| 3256 | WA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312416000000",
"number": "1962446948",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "126 E 2ND ST",
"city": "NORTH BEND",
"state": "WA",
"postal_code": "980459175",
"telephone_number": "425-831-2020",
"fax_number": "425-831-0027"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "126 E 2ND ST",
"city": "NORTH BEND",
"state": "WA",
"postal_code": "980459175",
"telephone_number": "425-831-2020",
"fax_number": "425-831-0027"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUVALL",
"first_name": "BRIAN",
"middle_name": "SCOTT",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-16",
"last_updated": "2011-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WA",
"license": "3256",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2025252",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in North Bend, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.