Individual provider Active NPI

Amanda Jane Brown, O.D.

  • Optometrist
  • Lubbock, TX
National Provider Identifier
1992945869
Registry record updated Sep 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
07231TG Issued in TX
Practice address
3104 Indiana Ave
Lubbock, TX 79410-3148
Phone
(806) 793-1927
Fax
(806) 791-4077
NPI assigned
Mar 4, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 07231TG TX Primary

Addresses

Primary practice location

3104 Indiana Ave
Lubbock, TX 79410-3148

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899

Other identifiers 1

IdentifierTypeStateIssuer
L0160250OtherTXTEXAS CONTROLLED SUBSTANCES REGISTRATION CERTIFICATE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20110329000790 TX Practitioner - Optometry 6608059696 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Med Southwest PLLCGroup PAC ID 4082952874, 234 clinicians

Practice addresses (Care Compare)

3104 Indiana Ave
Lubbock, TX 79410-3148
Phone (806) 793-1927

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
07231TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Med Southwest, PLLC Optometrist Current Accepting new patients
Med Southwest, PLLC Optometrist CurrentSince Nov 1, 2021 Accepting new patients
Med Southwest, PLLC Optometrist CurrentSince Nov 1, 2021 Accepting new patients
John J. Perez, O.D., P.C Optometrist PastSince Nov 22, 2010 Accepting new patients
Today'S Vision-Tomball, P.a. Optometrist Past Accepting new patients
April Oliver, P.a. Optometrist PastSince Sep 29, 2015 Accepting new patients

Locations

3104 Indiana Ave
Lubbock, TX 79410
Phone (803) 793-1927

2703 Richmond Rd
Texarkana, TX 75503
Phone (903) 838-0783

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

Interoperability endpoints

  • Direct secure messaging: dr.brown200811@vcwt.eyefinity-direct.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1236124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632960000000",
    "number": "1992945869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3104 INDIANA AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794103148",
            "telephone_number": "806-793-1927",
            "fax_number": "806-791-4077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "AMANDA",
        "middle_name": "JANE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-04",
        "last_updated": "2021-09-30",
        "certification_date": "2021-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "07231TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS CONTROLLED SUBSTANCES REGISTRATION CERTIFICATE",
            "identifier": "L0160250",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.