Active NPI
Ann Rene Braga, OPTICIAN
- Optometrist
- Twin Falls, ID
National Provider Identifier
1437248267
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OD485
- Practice address
- 691 Shoshone St N
Twin Falls, ID 83301-6154 - Phone
- (208) 733-1067
- Fax
- (208) 733-7597
- NPI assigned
- Oct 12, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OD485 | ID | Primary |
| Optician | 156FX1800X | 601I | AZ |
Addresses
Primary practice location
691 Shoshone St N
Twin Falls, ID 83301-6154
Mailing address
691 Shoshone St N
Twin Falls, ID 83301-6154
Phone (208) 733-1067
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| V2894 | Other | ID | BLUE CROSS |
| 000010014411 | Other | ID | BLUE SHIELD |
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
| License | State | Type | Specialty |
|---|---|---|---|
| OD485 | ID | MD | Optometrist |
| 601I | AZ | MD | Optician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anns Eyewear Boutique Inc | Optician | Current | Accepting new patients |
Locations
691 Shoshone St N
Twin Falls, ID 83301
Phone (208) 733-1067
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213142400000",
"number": "1437248267",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "691 SHOSHONE ST N",
"city": "TWIN FALLS",
"state": "ID",
"postal_code": "833016154",
"telephone_number": "208-733-1067",
"fax_number": "208-733-7597"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "691 SHOSHONE ST N",
"city": "TWIN FALLS",
"state": "ID",
"postal_code": "833016154",
"telephone_number": "208-733-1067",
"fax_number": "208-733-7597"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAGA",
"first_name": "ANN",
"middle_name": "RENE",
"name_prefix": "Mrs.",
"credential": "OPTICIAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-12",
"last_updated": "2008-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "ID",
"license": "OD485",
"primary": true
},
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "AZ",
"license": "601I",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "V2894",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "000010014411",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Twin Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.