Active NPI
Christopher Bradley Brocwell, O.D.
- Optometrist
- Miamisburg, OH
National Provider Identifier
1073685145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4916
- Practice address
- 7990 Springboro Pike
Miamisburg, OH 45342-3706 - Phone
- (937) 433-3937
- NPI assigned
- Nov 14, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4916 | OH | Primary |
Addresses
Primary practice location
7990 Springboro Pike
Miamisburg, OH 45342-3706
Mailing address
404 Crystal Point Dr
Dayton, OH 45459-4170
Phone (614) 361-1774
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 48626 | Other | OH | DAVIS VISION |
| 152221 | Other | OH | COLE VISION |
| 03638 | Other | OH | SPECTERA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4916 | OH | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1232668800000",
"number": "1073685145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "404 CRYSTAL POINT DR",
"city": "DAYTON",
"state": "OH",
"postal_code": "454594170",
"telephone_number": "614-361-1774"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7990 SPRINGBORO PIKE",
"city": "MIAMISBURG",
"state": "OH",
"postal_code": "453423706",
"telephone_number": "937-433-3937"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROCWELL",
"first_name": "CHRISTOPHER",
"middle_name": "BRADLEY",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-14",
"last_updated": "2009-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OH",
"license": "4916",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DAVIS VISION",
"identifier": "48626",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COLE VISION",
"identifier": "152221",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SPECTERA",
"identifier": "03638",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Miamisburg, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.