NPIMap

Organization Active NPI

Baird Optical PC

  • Optometrist
  • Chubbuck, ID
National Provider Identifier
1013206275
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ODP967 Issued in ID
Legal business name
BAIRD OPTICAL PC
Practice address
4240 Yellowstone Ave
Chubbuck, ID 83202-2420
Phone
(208) 238-2020
Fax
(208) 238-2069
NPI assigned
Mar 28, 2011
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Michael Baird, O.D.NPI 1457524555
Title
Ceo
Phone
(208) 709-0540

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X ODP967 ID Primary

Addresses

Primary practice location

4240 Yellowstone Ave
Chubbuck, ID 83202-2420

Mailing address

966 Old Glory Way
Chubbuck, ID 83202-1779
Phone (208) 709-0540

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1301270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1013206275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "966 OLD GLORY WAY",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832021779",
            "telephone_number": "208-709-0540",
            "fax_number": "208-238-2069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4240 YELLOWSTONE AVE",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832022420",
            "telephone_number": "208-238-2020",
            "fax_number": "208-238-2069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAIRD OPTICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-28",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BAIRD",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "208-709-0540",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chubbuck, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.