Robert M. Broaddus, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1591 Issued in KS

Practice address

13839 S Mur Len Rd Ste a
Olathe, KS 66062-1661

Phone

(913) 782-5993

NPI assigned

Dec 6, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Acuity Vision Center LLC

  • Optometrist
  • Olathe, KS
  • NPI 1679123590
  NPD (past)

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326107350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13839 S MUR LEN RD STE A",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660621661",
            "telephone_number": "913-782-5993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13839 S MUR LEN RD STE A",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660621661",
            "telephone_number": "913-782-5993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROADDUS",
        "first_name": "ROBERT",
        "middle_name": "M.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "30592028",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "1591",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paul J. Brinckman, O.D.
• Amanda Briones, CCC-SLP
• Cynthia Denise Briscoe, PT
• Cheryl Diane Brittain, CRNA
• Kaylah R Brixey
• Megan Walker Brockmeyer, PA
• Victoria Brody
• Samuel Cody Broll, MD
• Jessica N Brooks, APRN-NP
• Brookside Optical

• Optometrist in Olathe, KS
• Providers in Olathe, KS by specialty
• Optometrist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.