Organization Active NPI

Braaten Family Eye Care, LLC

  • Optometrist
  • New Albany, IN
National Provider Identifier
1063574820
Registry record updated Aug 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18003432A Issued in IN
Legal business name
BRAATEN FAMILY EYE CARE, LLC
Practice address
3602 Northgate CT
Ste 29
New Albany, IN 47150-6417
Phone
(812) 944-2021
Fax
(812) 945-0412
NPI assigned
Dec 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2011

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

Authorized official

Name
Dr. Marcus Richard Braaten, O.D.
Title
Member
Phone
(812) 944-2021

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 18003432A IN Primary

Addresses

Primary practice location

3602 Northgate CT
Ste 29
New Albany, IN 47150-6417

Mailing address

3602 Northgate CT
Ste 29
New Albany, IN 47150-6417
Phone (812) 944-2021

Other identifiers 1

IdentifierTypeStateIssuer
200844370AMedicaidIN

National Provider Directory

National Provider Directory

Locations

4214 Charlestown Rd
#3
New Albany, IN 47150
Phone (812) 944-2021

3602 Northgate Ct
Ste 29
New Albany, IN 47150
Phone (812) 944-2021

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313107200000",
    "number": "1063574820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3602 NORTHGATE CT",
            "address_2": "STE 29",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471506417",
            "telephone_number": "812-944-2021",
            "fax_number": "812-945-0412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3602 NORTHGATE CT",
            "address_2": "STE 29",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471506417",
            "telephone_number": "812-944-2021",
            "fax_number": "812-945-0412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAATEN FAMILY EYE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2011-08-12",
        "status": "A",
        "authorized_official_last_name": "BRAATEN",
        "authorized_official_first_name": "MARCUS",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "812-944-2021",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003432A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200844370A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Albany, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2011; 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.