DR. ICEM E BREWER (NPI# 1316166697) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316166697 |
| Entity Type | Individual |
| Full Name | DR. ICEM E BREWER |
| Credential | O.D. |
| Practice Address |
4201 N Shiloh Dr Ste 1235 Fayetteville AR 72703-5303 |
| Mailing Address |
2391 N Hidden Creek Dr Fayetteville AR 72704-6353 |
| Practice Telephone | 4794448705 |
| Mailing Telephone | 4792251857 |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2011-07-06 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152WC0802X |
Optometrist Specialization: Corneal and Contact Management |
2559 | AR | Eye and Vision Services Providers |
| Street Address |
4201 N SHILOH DR STE 1235 |
| City | FAYETTEVILLE |
| State | AR |
| Zip Code | 72703-5303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154391 | Margaret Sorrells | Pharmacist | 3909 N Mall Ave Attn:pharmacy, Fayetteville, AR 72703 | 2020-11-06 |
| 1497369631 | Justin A Rand | Massage Therapist | 88 W Colt Square Dr, Fayetteville, Ar 72703, Fayetteville, AR 72703 | 2020-09-04 |
| 1235777558 | Washington Regional Medical System | Specialist | 3264 N North Hills Blvd, Fayetteville, AR 72703 | 2019-12-17 |
| 1760024582 | Haley Brooke Thompson | Occupational Therapist | 2474 E Joyce Blvd Ste 2, Null, Fayetteville, AR 72703 | 2019-10-14 |
| 1306492129 | Bhg L, LLC | Clinic/Center | 8 Colt Square Drive, Fayetteville, AR 72703 | 2019-08-16 |
| 1306406269 | Idell Marie Mitchell | Optometrist | Eye Clinic, 1100 N College Ave, Fayetteville, AR 72703 | 2019-06-13 |
| 1821574815 | Toni Myer | Nurse Practitioner | 3 E Appleby Rd Ste 101, Fayetteville, AR 72703 | 2018-07-13 |
| 1306340393 | Josh Kelfer | Student in an Organized Health Care Education/Training Program | 1125 North College Avenue, Fayetteville, AR 72703 | 2018-03-22 |
| 1649726449 | Vantage Point of Nwa | Community/Behavioral Health | 4171 N. Crossover Rd, Fayetteville, AR 72703 | 2016-08-31 |
| 1386097137 | Jason Nordstrom | Speech-Language Pathologist | 2664 N Valencia Ave, Fayetteville, AR 72703 | 2016-07-18 |
| Find all providers in zip 72703 | ||||
| Taxonomy Code | 152WC0802X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Specialization | Corneal and Contact Management |
| The professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea’s ability to sustain successful contact lens wear, and treatment of any external eye or corneal condition which can affect contact lens wear. |
| Notes: Source: American Optometric Association [1/1/2009: added definition, added source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750595757 | Dr. Clifford M Turner II Od | Optometrist | 116 East Second St., Carlisle, AR 72024-0859 | 2007-05-09 |
| 1568597409 | Kerry Childers, O.d., P.a. | Optometrist | 618 Julia Ave E, Wynne, AR 72396-3504 | 2007-02-22 |
| 1598836066 | Rick D Ray | Optometrist | 2 Riviera Dr, Booneville, AR 72927-0295 | 2006-11-13 |
| 1780773481 | Chris Deitrick Od Pa | Optometrist | 202 Peabody St, Mountain View, AR 72560-1460 | 2006-10-12 |
| 1194817676 | Robert Frank Castiglione | Optometrist | 787 6th St, Little Rock Air Force Base, AR 72099-4947 | 2006-09-29 |
| 1114906310 | Kerry K Childers | Optometrist | 723 Falls Blvd S, Ste A, Wynne, AR 72396-3508 | 2006-01-16 |
| 1124028493 | Charles G Crosslin | Optometrist | 7345 Highway 62 W, Gassville, AR 72635 | 2005-07-28 |
| 1669470183 | Chris Deitrick | Optometrist | 202 Peabody, Mountain View, AR 72560 | 2005-07-08 |
| 1801100623 | Patrick Fowler O.d. P.a. | Optometrist | 5501 S Olive St, Pine Bluff, AR 71603-7607 | 2010-08-04 |
| 1669591129 | Richard Foster | Optometrist | 2000 John Harden Dr, Jacksonville, AR 72076-2730 | 2007-03-28 |
| Find all providers with the same taxonomy | ||||
| City | FAYETTEVILLE |
| Zip Code | 72703 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.