Robert M. Brenner O.D.

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

3398 Issued in OH

Legal business name

ROBERT M. BRENNER O.D.

Practice address

70 Park Ave W
Mansfield, OH 44902-1624

Phone

(419) 525-1207

Fax

(419) 525-0030

NPI assigned

Nov 19, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Robert M. Brenner, O.D.

Title

Owner

Phone

(419) 525-0030

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1195430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282608000000",
    "number": "1437330446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 PARK AVE W",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449021624",
            "telephone_number": "419-525-1207",
            "fax_number": "419-525-0030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 PARK AVE W",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449021624",
            "telephone_number": "419-525-1207",
            "fax_number": "419-525-0030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT M. BRENNER O.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-19",
        "last_updated": "2010-08-24",
        "status": "A",
        "authorized_official_last_name": "BRENNER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "419-525-0030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "OH",
            "license": "3398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2036255",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Eyewear Supplier in Mansfield, OH
• Providers in Mansfield, OH by specialty
• Eyewear Supplier in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2010; 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.