Brandi Lea Hathorne, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618001844 Issued in VA

Practice address

9785 Jefferson Davis Hwy
Fredericksburg, VA 22407

Phone

(540) 891-1290

Fax

(540) 834-4289

NPI assigned

Jul 13, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Brandi Lea Young Former name

Medicare fee-for-service enrollment

Enrolled in VA

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1247443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529884800000",
    "number": "1376772319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9785 JEFFERSON DAVIS HWY",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224079406",
            "telephone_number": "540-891-1290",
            "fax_number": "540-834-4289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9785 JEFFERSON DAVIS HWY",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "22407",
            "telephone_number": "540-891-1290",
            "fax_number": "540-834-4289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATHORNE",
        "first_name": "BRANDI",
        "middle_name": "LEA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-13",
        "last_updated": "2018-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001844",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA2170",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRANDI",
            "last_name": "YOUNG",
            "middle_name": "LEA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lucas Scott Hastings
• Sarah Hastings
• Jared Ronald Hatch, DC
• Taylor Hatchel
• Helen Hathaway
• Chris Hawkins
• Michael Hawkins, CSAC, NCAC II
• Danielle Denise Hawley, CRNA
• Torrey Hawley, CRNA
• Stephanie Hayden, LPC

• Optometrist in Fredericksburg, VA
• Providers in Fredericksburg, VA by specialty
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.