Brett C Reynolds OD PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC3269 Issued in FL

Legal business name

BRETT C REYNOLDS OD PA

Practice address

3830 S Highway A1A
Unit 11
Melbourne Beach, FL 32951-3143

Phone

(321) 308-2015

Fax

(321) 308-2017

NPI assigned

Feb 4, 2008

Organization subpart

No

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

Authorized official

Name

Brett Courtney ReynoldsNPI 1942346911

Title

President

Phone

(321) 308-2015

Specialties & licenses 1

Addresses

Other names 1

• Driftwood Vision Center Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Tax ID family

Brett C Reynolds OD PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Driftwood Vision Center

  • Optometrist
  • Patrick Air Force Base, FL
  • NPI 1134589732
  NPD tax ID

Locations

Practitioners 1

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

• Brett Reynolds, OD

  • Optometrist
  • Melbourne Beach, FL
  • NPI 1942346911

  FL, Optometrist

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1202083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210809600000",
    "number": "1306024286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3830 S HIGHWAY A1A",
            "address_2": "UNIT 11",
            "city": "MELBOURNE BEACH",
            "state": "FL",
            "postal_code": "329513143",
            "telephone_number": "321-308-2015",
            "fax_number": "321-308-2017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3830 S HIGHWAY A1A",
            "address_2": "UNIT 11",
            "city": "MELBOURNE BEACH",
            "state": "FL",
            "postal_code": "329513143",
            "telephone_number": "321-308-2015",
            "fax_number": "321-308-2017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRETT C REYNOLDS OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-04",
        "last_updated": "2008-05-15",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "COURTNEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-308-2015"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Driftwood Vision Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Autism Therapy ABA Services LLC
• Beachnspeech
• Kara Beres, LMHC
• Nicole Bladin, ARNP
• Joseph E Bonar, PT
• Carl V Bundschuh, MD
• Jimmie Dean Canole
• Benita Carson
• Collins & Montz, D.M.D., P.a.
• James Hunter Collins, D.M.D.

• Optometrist in Melbourne Beach, FL
• Providers in Melbourne Beach, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.