Active NPI
Nancy Bragaw Patten
- Optician
- Fort Myers, FL
National Provider Identifier
1194952572
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- DO5760
- Practice address
- 4790 Barkley Cir BLDG C-103
Fort Myers, FL 33907-7543 - Phone
- (239) 936-8686
- Fax
- (239) 936-2532
- NPI assigned
- Jun 12, 2009
- Sex
- Female
- Sole proprietor
- No
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 | DO5760 | FL | Primary |
Addresses
Primary practice location
4790 Barkley Cir BLDG C-103
Fort Myers, FL 33907-7543
Mailing address
4790 Barkley Cir BLDG C-103
Fort Myers, FL 33907-7543
Phone (239) 936-8686
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 |
|---|---|---|---|
| DO5760 | FL | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1300924800000",
"number": "1194952572",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4790 BARKLEY CIR BLDG C-103",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339077543",
"telephone_number": "239-936-8686",
"fax_number": "239-936-2532"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4790 BARKLEY CIR BLDG C-103",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339077543",
"telephone_number": "239-936-8686",
"fax_number": "239-936-2532"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAGAW PATTEN",
"first_name": "NANCY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-12",
"last_updated": "2011-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "FL",
"license": "DO5760",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.