Active NPI
Bradley Peter Bohman, LO
- Optician
- Waterford, CT
National Provider Identifier
1023245776
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 632
- Practice address
- Vision Center
155 Waterford Pkwy North
Waterford, CT 06385 - Phone
- (860) 437-3748
- NPI assigned
- Jun 19, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 632 | CT | Primary |
Addresses
Primary practice location
Vision Center
155 Waterford Pkwy North
Waterford, CT 06385
Mailing address
38 Oak St
Westerly, RI 02891-1741
Phone (401) 596-9482
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 581910859 | Other | CT | TAX ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1245369600000",
"number": "1023245776",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38 OAK ST",
"city": "WESTERLY",
"state": "RI",
"postal_code": "028911741",
"telephone_number": "401-596-9482"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "VISION CENTER",
"address_2": "155 WATERFORD PKWY NORTH",
"city": "WATERFORD",
"state": "CT",
"postal_code": "06385",
"telephone_number": "860-437-3748"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOHMAN",
"first_name": "BRADLEY",
"middle_name": "PETER",
"name_prefix": "Mr.",
"credential": "LO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-06-19",
"last_updated": "2009-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "CT",
"license": "632",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "581910859",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waterford, CT
- Tracy Blasioli, L.C.S.W.
- Christopher Blimberg, DPT
- Bloom Behavior and Consulting Services
- Bloom Behavior Consulting Services LLC
- Heather Nicole Bodie, LCSW
- David S Boisoneau, M.D.
- Juliet Lacaran Boltz, MASSAGE THERAPIST
- Alan Wilfred Bonin, LMHC, LADC, LPC
- David Alan Brill, M.D.
- Cynthia Ann Brown, LPC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.