Bryce B. Thueson, O.D., PLLC

Key facts

NPI

1457716482

Entity type

Organization (NPI type 2)

Primary specialty

Optometrist 152W00000X

License

ODP100014 (ID)

Legal business name

BRYCE B. THUESON, O.D., PLLC

Practice address

76 Professional PLZ
Rexburg, ID 83440-2047

Phone

(208) 356-4585

Fax

(208) 356-4587

NPI assigned

Dec 17, 2015

Organization subpart

No

Authorized official

Name

Dr. Bryce B Thueson, O.D. NPI 1144260969

Title

Owner

Phone

(208) 356-4585

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

Practitioners 3

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

• Bryce Byram Thueson, O.D. Optometrist · Rexburg, ID · NPI 1144260969
  Medicare reassignment Care Compare group NPD Authorized official ID · OPTOMETRIST
• Kreed Bowman, O.D. Optometrist · Rexburg, ID · NPI 1093168767
  Medicare reassignment Care Compare group NPD ID · OPTOMETRIST
• Kent M. Archibald, O.D. Optometrist · Rexburg, ID · NPI 1851336721
  NPD OPTOMETRIST

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare participation

Medicare fee-for-service enrollment

Enrolled (2 enrollments) in ID

Medicare enrollment records

National Provider Directory

Locations

Specialties & licenses

Addresses

Other names

• Today's Eye Care Doing business as

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 17, 2015.

{
    "created_epoch": "1450310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450310400000",
    "number": "1457716482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 PROFESSIONAL PLZ",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834402047",
            "telephone_number": "208-356-4585",
            "fax_number": "208-356-4587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 PROFESSIONAL PLZ",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834402047",
            "telephone_number": "208-356-4585",
            "fax_number": "208-356-4587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRYCE B. THUESON, O.D., PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-17",
        "last_updated": "2015-12-17",
        "status": "A",
        "authorized_official_last_name": "THUESON",
        "authorized_official_first_name": "BRYCE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-356-4585",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP100014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Today's Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rexburg, ID

• Pamela Brown, LCPC
• Rosemary H Brown, FNP-C
• Michael Brunson, PHARMD
• Shelby Renee Brunson
• Zachery M Brunson, PA-C
• Rayo Pascal Budge, LPC
• Jeremiah D Buehner, PA
• Brandon M Buhler, LMFT
• Tiffany Nudcha Burgess
• Burke Non-Emergency Medical Transport, LLC

All providers in Rexburg, ID · Optometrist in Idaho