NPIMap

Organization Active NPI

Dr Verlyn Broek

  • Optometrist
  • Twin Falls, ID
National Provider Identifier
1457538605
Registry record updated Jan 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
O-542 Issued in ID
Legal business name
DR VERLYN BROEK
Practice address
215 4TH Ave N
Twin Falls, ID 83301-6139
Phone
(208) 734-5100
NPI assigned
Jan 29, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2008

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

Authorized official

Name
Verlyn Broek, O.D.NPI 1760559223
Title
Owner
Phone
(208) 734-5100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X O-542 ID Primary

Addresses

Primary practice location

215 4TH Ave N
Twin Falls, ID 83301-6139

Mailing address

215 4TH Ave N
Twin Falls, ID 83301-6139
Phone (208) 734-5100

National Provider Directory

National Provider Directory

Locations

215 4th Ave N
Twin Falls, ID 83301
Phone (208) 434-5100

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1201564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201564800000",
    "number": "1457538605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 4TH AVE N",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833016139",
            "telephone_number": "208-734-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 4TH AVE N",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833016139",
            "telephone_number": "208-734-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR VERLYN BROEK",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-29",
        "last_updated": "2008-01-29",
        "status": "A",
        "authorized_official_last_name": "BROEK",
        "authorized_official_first_name": "VERLYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-734-5100",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "ID",
            "license": "O-542",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jan 29, 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.

Verify at the official NPI Registry.