PEDIATRIC VISION DEVELOPMENT CENTER INC. (NPI# 1558427021) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558427021 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC VISION DEVELOPMENT CENTER INC. |
| Practice Address |
101 Dawn Dr Centerton AR 72719-9314 |
| Practice Telephone | 4797951411 |
| Practice Fax Number | 4797951412 |
| Mailing Telephone | 4797951411 |
| Mailing Fax Number | 4797951412 |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2013-12-18 |
| Authorized Official Name | DR. MEGAN PETTY (PRESIDENT) |
| Authorized Official Telephone | 4797951411 |
| Authorized Official Credential | OD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152WV0400X |
Optometrist Specialization: Vision Therapy |
2568 | AR | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | STATE LICENSE | 2568 | 01 |
| Street Address |
101 DAWN DR |
| City | CENTERTON |
| State | AR |
| Zip Code | 72719-9314 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255332433 | Megan Jo Petty | Optometrist | 101 Dawn Dr, Centerton, AR 72719-9314 | 2005-08-10 |
| 1730556580 | Jacob Dufour | Optometrist | 101 Dawn Dr, Centerton, AR 72719-9314 | 2015-08-27 |
| 1457412991 | Petty and Petty, P. A. | Optometrist | 101 Dawn Dr, Centerton, AR 72719-9314 | 2006-12-12 |
| 1588666499 | Regan Skye Petty | Optometrist | 101 Dawn Dr, Centerton, AR 72719 | 2005-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669086724 | Epic Smiles Pllc | Dentist | 310 E Centerton Blvd, Centerton, AR 72719 | 2020-09-04 |
| 1134733876 | Bradley R Crossfield Dds Pllc | Clinic/Center | 880 East Centerton Blvd, Suite A, Centerton, AR 72719 | 2020-09-01 |
| 1861967291 | Apexnetwork Arkansas, LLC | Physical Therapist | 1128 E. Centerton Blvd, Centerton, AR 72719 | 2018-10-12 |
| 1568975761 | Reeves Medical Associates, Pllc | Internal Medicine | 1415 E Centerton Blvd, Centerton, AR 72719 | 2017-11-09 |
| 1164948246 | Jodie A Bone | Behavioral Analyst | 450 Walker Street, Centerton, AR 72719 | 2017-08-21 |
| 1225581606 | Andrew Jason Phipps | Dentist | 807 West Centerton Blvd, Centerton, AR 72719 | 2016-08-02 |
| 1922429158 | Chelsea Kinney | Speech-Language Pathologist | 427 Centerton Blvd, Centerton, AR 72719 | 2013-12-13 |
| 1467707166 | Stacey Kirk | Case Manager/Care Coordinator | 250 East Centerton Blvd., Centerton, AR 72719 | 2012-07-18 |
| 1295994457 | Tracie Leanne Downey | Occupational Therapist | 675 Brimwood Street, Centerton, AR 72719 | 2008-06-03 |
| 1124228382 | Carolyn R Reeves | Internal Medicine | 1415 E Centeron Blvd, Centeron, AR 72719 | 2007-07-24 |
| Find all providers in zip 72719 | ||||
| Taxonomy Code | 152WV0400X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Specialization | Vision Therapy |
| Optometrists who specialize in vision therapy as a treatment process used to improve vision function. It includes a broad range of developmental and rehabilitative treatment programs individually prescribed to remediate specific sensory, motor and/or visual perceptual dysfunctions. |
| Notes: Source: American Optometric Association [1/1/2009: added definition, added source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255332433 | Megan Jo Petty | Optometrist | 101 Dawn Dr, Centerton, AR 72719-9314 | 2005-08-10 |
| 1730556580 | Jacob Dufour | Optometrist | 101 Dawn Dr, Centerton, AR 72719-9314 | 2015-08-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255593232 | Dr Bryan Caplinger Pa | Optometrist | 116 Nathan, Marked Tree, AR 72365 | 2008-06-30 |
| 1447387170 | Wanda Vaughn | Optometrist | 1021 S Waldron Rd, Fort Smith, AR 72903-2549 | 2007-02-28 |
| 1538563895 | Vision Therapy Center of Jonesboro, P.l.l.c. | Optometrist | 3705 E Johnson Ave, Suite B, Jonesboro, AR 72401-1858 | 2014-10-15 |
| 1942326244 | Arkansas Vision Development Center Pa | Optometrist | 1021 S Waldron Rd, Fort Smith, AR 72903-2549 | 2007-03-21 |
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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.