BRADLEY BYWATER (NPI# 1407159890) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407159890 |
| Entity Type | Individual |
| Full Name | BRADLEY BYWATER |
| Credential | O.D. |
| Practice Address |
85 W Combs Rd Ste 108 San Tan Valley AZ 85140-9107 |
| Mailing Address |
220 N Mckemy Ave Chandler AZ 85226-2654 |
| Practice Telephone | 6022394286 |
| Mailing Telephone | 4809611865 |
| Mailing Fax Number | 4809614605 |
| Enumeration Date | 2010-12-07 |
| Last Update Date | 2018-02-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152W00000X | Optometrist | 956 | NV | Eye and Vision Services Providers |
| Y | 152W00000X | Optometrist | 1783 | AZ | Eye and Vision Services Providers |
| Street Address |
85 W COMBS RD STE 108 |
| City | SAN TAN VALLEY |
| State | AZ |
| Zip Code | 85140-9107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578189346 | Matthew Gillon | Optometrist | 85 W Combs Rd Ste 108, San Tan Valley, AZ 85140-9107 | 2020-06-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801429634 | Bhsm Rehabilitation, LLC | Clinic/Center | 37200 North Gantzel Road, Suite 260, Queen Creek, AZ 85140 | 2020-02-20 |
| 1801455712 | Jose Enrique Knox | Specialist/Technologist, Other | 36018 North Secret Garden Path, Queen Creek, AZ 85140 | 2019-06-13 |
| 1629546171 | San Tan Valley Oral Facial and Implant Surgery Pllc | Oral & Maxillofacial Surgery | 36327 N Gantzel Rd, Suite 102, San Tan Valley, AZ 85140 | 2018-11-02 |
| 1780164582 | Safeway Inc | Durable Medical Equipment & Medical Supplies | 40950 N Ironwood Dr, Queen Creek, AZ 85140 | 2018-08-21 |
| 1497249452 | San Tan Primary Care PC | Family Medicine | 36283 N Gantzel Rd Ste 101, San Tan Valley, AZ 85140 | 2018-06-21 |
| 1306386115 | Veronica Gonzalez | Licensed Practical Nurse | 733 E Angeline Ave, Queen Creek, AZ 85140 | 2017-02-27 |
| 1194198697 | Amanda Ellis | Residential Treatment Facility, Physical Disabilities | 381 East Brook Street, San Tan Valley, AZ 85140 | 2015-11-05 |
| 1043688336 | Felicia D Adams | Day Training/Habilitation Specialist | 1074 E. Press Rd, San Tan Valley, AZ 85140 | 2015-09-03 |
| 1376928598 | Amy Burks | Physical Therapy Assistant | 1479 E Oak Rd, San Tan Valley, AZ 85140 | 2015-07-29 |
| 1316367121 | Shanaya Suchak | Internal Medicine | 37000 N Gantzel Road, Attn: Hospitalists, San Tan Valley, AZ 85140 | 2014-04-19 |
| Find all providers in zip 85140 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144567173 | Clasik Vision Care Pllc | Optometrist | 3125 W Hunt Hwy # B-102, San Tan Valley, AZ 85142-9315 | 2013-01-10 |
| 1578189346 | Matthew Gillon | Optometrist | 85 W Combs Rd Ste 108, San Tan Valley, AZ 85140-9107 | 2020-06-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326653528 | Kelsey Harraghy | Optometrist | 7700 W Arrowhead Towne Ctr Ste 1136, Glendale, AZ 85308-0926 | 2020-09-14 |
| 1831701218 | West Point Optical Group | Optometrist | 24775 N. Pleasant Pkwy, Peoria, AZ 85383 | 2020-08-18 |
| 1922610302 | West Point Optical Group | Optometrist | 10706 E Point Twenty-two Blvd, #107, Mesa, AZ 85212 | 2020-08-18 |
| 1093326688 | West Point Optical | Optometrist | 15681 N Hayden Rd Ste 115, Scottsdale, AZ 85260-1959 | 2020-08-17 |
| 1275143034 | Kelly Hart | Optometrist | 7111 N Oracle Rd, Tucson, AZ 85704-4331 | 2020-08-06 |
| 1689283830 | Kelsie Stevens | Optometrist | 6815 N 19th Ave Ste 130, Phoenix, AZ 85015-1135 | 2020-07-23 |
| 1053939306 | Corey Dunlop | Optometrist | 1025 S Power Rd Ste 102, Mesa, AZ 85206-5240 | 2020-07-13 |
| 1134747801 | National Vision Inc | Optometrist | 1838 W Bell Rd, Phoenix, AZ 85023-3480 | 2020-07-09 |
| 1144848912 | Miranda Hueners | Optometrist | 2040 E Rio Salado Pkwy Ste 120, Tempe, AZ 85281-5185 | 2020-07-08 |
| 1770109282 | Nathan Jones | Optometrist | 6135 N 35th Ave Ste 139, Phoenix, AZ 85017-1953 | 2020-06-20 |
| Find all providers with the same taxonomy | ||||
| City | SAN TAN VALLEY |
| Zip Code | 85140 |
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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.