Stacy Allison Bragg, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

12909 Issued in CA

Practice address

7901 Watt Ave
Antelope, CA 95843-2000

Phone

(916) 332-4904

NPI assigned

Mar 5, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, NY2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Empire Vision Center Inc

  dba Davis Vision

  • Optometrist
  • Syracuse, NY
  • NPI 1750358826
  Medicare reassignment NPD
• Empire Vision Center, Inc

  dba Visionworks

  • Eyewear Supplier
  • Attleboro, MA
  • NPI 1730635582
  NPD

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447389796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3633 KINGSPORT WAY",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958265247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 WATT AVE",
            "city": "ANTELOPE",
            "state": "CA",
            "postal_code": "958432000",
            "telephone_number": "916-332-4904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAGG",
        "first_name": "STACY",
        "middle_name": "ALLISON",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Jeanne Bishop
• William John Black, D.D.S.
• Alina Borisova
• Irina Bortnovsky
• Thomas Gar on Boyce, PHARMD
• Brian C Crawford and Paolo a Poidmore, a Dental Corporation (Precision Orthodontics)
• Rhonda Shirell Calvin, LMFT
• Caring Hearts Transportation, LLC
• Chante Laniece Carnes, BEHAVIOR TECHNICIAN
• Center Unified School District

• Optometrist in Antelope, CA
• Providers in Antelope, CA by specialty
• Optometrist in California

• 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.
• 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.