Individual provider Active NPI

Sheri Lynn Brooks, ABOC,COA,RA

  • Optician
  • Portland, OR
National Provider Identifier
1265663173
Registry record updated Jul 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
22027 Issued in OR
Practice address
5574 SE Ash St
Portland, OR 97215-1247
Phone
(503) 260-8591
Fax
(503) 236-5049
NPI assigned
Jul 28, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmic Assistant 156FX1101X 96750 OR
Optician 156FX1800X 22027 OR Primary

Addresses

Primary practice location

5574 SE Ash St
Portland, OR 97215-1247

Mailing address

5574 SE Ash St
Portland, OR 97215-1247
Phone (503) 260-8591

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

LicenseStateTypeSpecialty
96750ORMDOphthalmic Assistant
22027ORMDOptician

NPI Registry JSON

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

{
    "created_epoch": "1248739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248739200000",
    "number": "1265663173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5574 SE ASH ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972151247",
            "telephone_number": "503-260-8591",
            "fax_number": "503-236-5049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5574 SE ASH ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972151247",
            "telephone_number": "503-260-8591",
            "fax_number": "503-236-5049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "SHERI",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "ABOC,COA,RA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-28",
        "last_updated": "2009-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1101X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Ophthalmic Assistant",
            "state": "OR",
            "license": "96750",
            "primary": false
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "OR",
            "license": "22027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2009; 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.