Organization Active NPI

J. Brian Conran, O.D., S.C.

  • Optometrist
  • Fond Du Lac, WI
National Provider Identifier
1235408154
Registry record updated Dec 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
324235 Issued in WI
Legal business name
J. BRIAN CONRAN, O.D., S.C.
Practice address
110 E Division St
Fond Du Lac, WI 54935-4369
Phone
(920) 922-5430
Fax
(920) 922-5478
NPI assigned
Dec 21, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2011

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

Authorized official

Name
Dr. J Brian Conran, O.D.
Title
Owner
Phone
(920) 922-5430

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 324235 WI Primary

Addresses

Primary practice location

110 E Division St
Fond Du Lac, WI 54935-4369

Mailing address

110 E Division St
Fond Du Lac, WI 54935-4369
Phone (920) 922-5430

National Provider Directory

National Provider Directory

Locations

110 E Division St
Fond du Lac, WI 54935
Phone (920) 922-5430

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1324425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324425600000",
    "number": "1235408154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E DIVISION ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549354369",
            "telephone_number": "920-922-5430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E DIVISION ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549354369",
            "telephone_number": "920-922-5430",
            "fax_number": "920-922-5478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J. BRIAN CONRAN, O.D., S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-21",
        "last_updated": "2011-12-21",
        "status": "A",
        "authorized_official_last_name": "CONRAN",
        "authorized_official_first_name": "J",
        "authorized_official_middle_name": "BRIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-922-5430",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WI",
            "license": "324235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fond Du Lac, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.

Verify at the official NPI Registry.