Annette Brabham, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OP0002698 Issued in FL

Practice address

111 N John Sims Pkwy
Valparaiso, FL 32580

Phone

(850) 729-8711

Fax

(850) 729-8713

NPI assigned

Oct 3, 2006

Sex

Female

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 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern College of Optometry, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Branscome Vision Group IncGroup PAC ID 9335644756, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: abrabham@baysidevisioncenter.eyefinity-direct.com

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

• Annette Brabham OD PA

  • Optometrist
  • Valparaiso, FL
  • NPI 1255635348
  Medicare reassignment NPD Authorized official
• Branscome Vision Group Inc

  • Optometrist
  • Valparaiso, FL
  • NPI 1346123320
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529020800000",
    "number": "1346334422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N JOHN SIMS PKWY",
            "city": "VALPARAISO",
            "state": "FL",
            "postal_code": "325801005",
            "telephone_number": "850-729-8711",
            "fax_number": "850-729-8713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N JOHN SIMS PKWY",
            "city": "VALPARAISO",
            "state": "FL",
            "postal_code": "32580",
            "telephone_number": "850-729-8711",
            "fax_number": "850-729-8713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRABHAM",
        "first_name": "ANNETTE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2018-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OP0002698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620523200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Annette Brabham OD PA
• Clarissa Ashford
• Brandie Jennell Bachman, MASSAGE THERAPIST
• Wyndal K Blankenship, MD
• Branscome Vision Group Inc
• Sharon Marie Branscome, O.D.
• Mary Catherine Brogdon, L.P.N
• C S Peters OD, PA
• Thaddaeus R Castaneda, M.D.

• Optometrist in Valparaiso, FL
• Providers in Valparaiso, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.