Organization Active NPI

Brown Family Vision, P.C.

  • Optometrist
  • Grangeville, ID
National Provider Identifier
1154590909
Registry record updated May 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
BROWN FAMILY VISION, P.C.
Practice address
622 W North St
Grangeville, ID 83530-1240
Phone
(208) 983-0260
NPI assigned
Feb 26, 2008
Last updated
May 17, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2012

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

Authorized official

Name
Joel I Brown, O.D.NPI 1891780334
Title
President
Phone
(208) 983-0260

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary
Eyewear Supplier 332H00000X 0-869 ID

Addresses

Primary practice location

622 W North St
Grangeville, ID 83530-1240

Mailing address

622 W North St
Grangeville, ID 83530-1240
Phone (208) 983-0260

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20101014001252 ID DME Supplier - Physician - Optometrist 2264625870 Practice locations: Grangeville, ID
O20120120000583 ID Part B Supplier - Clinic/Group Practice 2264625870 Receives reassigned benefits from 1 practitioner
Practice locations: Grangeville, ID

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Brown Family Vision622 W North St, Grangeville, ID 83530-1240(208) 983-2020 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory

Locations

622 W North St
Grangeville, ID 83530
Phone (208) 903-0260

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.

NPI Registry JSON

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

{
    "created_epoch": "1203984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337212800000",
    "number": "1154590909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 W NORTH ST",
            "city": "GRANGEVILLE",
            "state": "ID",
            "postal_code": "835301240",
            "telephone_number": "208-983-0260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 W NORTH ST",
            "city": "GRANGEVILLE",
            "state": "ID",
            "postal_code": "835301240",
            "telephone_number": "208-983-0260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROWN FAMILY VISION, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-26",
        "last_updated": "2012-05-17",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "JOEL",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-983-0260",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "ID",
            "license": "0-869",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grangeville, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.