Active NPI
Brittany L Boardwine, LDO
- Optician
- Lebanon, VA
National Provider Identifier
1114743986
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 1101004583
- Practice address
- 1050 Regional Park Rd
Lebanon, VA 24266-3712 - Phone
- (276) 889-3717
- NPI assigned
- Nov 26, 2024
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Optician | 156FX1800X | 1101004583 | VA | Primary |
Addresses
Primary practice location
1050 Regional Park Rd
Lebanon, VA 24266-3712
Mailing address
1050 Regional Park Rd
Lebanon, VA 24266-3712
Phone (276) 889-3717
Other names 1
- Brittany L Smith
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 |
|---|---|---|---|
| 1101004583 | VA | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1732579200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732579200000",
"number": "1114743986",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1050 REGIONAL PARK RD",
"city": "LEBANON",
"state": "VA",
"postal_code": "242663712",
"telephone_number": "276-889-3717"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1050 REGIONAL PARK RD",
"city": "LEBANON",
"state": "VA",
"postal_code": "242663712",
"telephone_number": "276-889-3717"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOARDWINE",
"first_name": "BRITTANY",
"middle_name": "L",
"credential": "LDO",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-11-26",
"last_updated": "2024-11-26",
"certification_date": "2024-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "VA",
"license": "1101004583",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "BRITTANY",
"last_name": "SMITH",
"middle_name": "L",
"credential": "LDO",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Lebanon, VA
- Blue Ridge Medical Management Corporation
- Blue Ridge Medical Management Corporation
- Blue Ridge Medical Management Corporation
- Blue Ridge Medical Managment Corporation
- Blue Ridge Medical Mangement Corporation
- Ramona L Boyd, NP
- Lisa Marie Brooks, MS CCC SLP
- Peter J Bruzzo, DO
- Amy Amanda Bryant, DO
- Rebekah Jo Burkett, PT, DPT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.