Individual provider Active NPI

Bryan Douglas Brown, O.D.

  • Optometrist
  • Conway, AR
National Provider Identifier
1972594323
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4020 Issued in AR
Practice address
3900 Dave Ward Dr
Conway, AR 72034-5583
Phone
(501) 358-0471
Fax
(501) 328-9581
NPI assigned
Nov 3, 2005
Last updated
Jul 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X R132TA436 AL
Optometrist 152W00000X 4020 AR Primary

Addresses

Primary practice location

3900 Dave Ward Dr
Conway, AR 72034-5583

Mailing address

1501 Dogwood TRL
Conway, AR 72032-8044
Phone (334) 333-3286

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200601000448 AR Practitioner - Optometry 3476546631 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4020ARMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Swift Optometry Care PC Optometrist CurrentSince Jan 26, 2025 Accepting new patients
Bryan Brown, OD LLC Optometrist CurrentSince Sep 15, 2024 Accepting new patients
John T. Bender, Jr., O.D., P.C. Optometrist Past Accepting new patients
Eye Partners PC Past Accepting new patients

Locations

1975 White Dr
Batesville, AR 72501
Phone (870) 376-0346

3900 Dave Ward Dr
Conway, AR 72034
Phone (501) 328-5000

250 Skillman St
Ste 202
Brooklyn, NY 11205

Organizations & group practices 4

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": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1972594323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 DOGWOOD TRL",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720328044",
            "telephone_number": "334-333-3286",
            "fax_number": "501-328-9581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 DAVE WARD DR",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720345583",
            "telephone_number": "501-358-0471",
            "fax_number": "501-328-9581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "BRYAN",
        "middle_name": "DOUGLAS",
        "name_prefix": "Mr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "R132TA436",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "4020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, AR

Sources for this page

Verify at the official NPI Registry.