Active NPI
Driftwood Vision Center
- Optometrist
- Patrick Air Force Base, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPC3269
- Legal business name
- DRIFTWOOD VISION CENTER
- Practice address
- 1221 S Patrick Dr
Suite 104
Patrick Air Force Base, FL 32925-3623 - Phone
- (321) 783-8820
- NPI assigned
- Feb 25, 2016
- Last updated
- Feb 25, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Brett C Reynolds, OD
- Title
- President
- Phone
- (321) 783-8820
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPC3269 | FL | Primary |
Addresses
Primary practice location
1221 S Patrick Dr
Suite 104
Patrick Air Force Base, FL 32925-3623
Mailing address
1221 S. Patrick Drive
Suite 104
Patrick Air Force Base, FL 32925
Phone (321) 783-8820
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20933 | Other | FL | BCBS |
National Provider Directory
National Provider Directory- Tax ID family
- Brett C Reynolds OD PA
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the 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.
-
- Optometrist
- Melbourne Beach, FL
- NPI 1942346911
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1456358400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1456358400000",
"number": "1134589732",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1221 S. PATRICK DRIVE",
"address_2": "SUITE 104",
"city": "PATRICK AIR FORCE BASE",
"state": "FL",
"postal_code": "32925",
"telephone_number": "321-783-8820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1221 S PATRICK DR",
"address_2": "SUITE 104",
"city": "PATRICK AIR FORCE BASE",
"state": "FL",
"postal_code": "329253623",
"telephone_number": "321-783-8820"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DRIFTWOOD VISION CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2016-02-25",
"last_updated": "2016-02-25",
"status": "A",
"authorized_official_last_name": "REYNOLDS",
"authorized_official_first_name": "BRETT",
"authorized_official_middle_name": "C",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "321-783-8820",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "OD"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "FL",
"license": "OPC3269",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "20933",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Patrick Air Force Base, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.