Lacey B Brenner, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

0002932 Issued in CO

Practice address

250 Max Dr
Suite 101
Castle Pines, CO 80108-9517

Phone

(303) 688-5066

Fax

(303) 688-6986

NPI assigned

Feb 4, 2011

Last updated

May 28, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Abba Eye Care PC

  • Optometrist
  • Colorado Springs, CO
  • NPI 1952301129
  NPD (past)

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

{
    "created_epoch": "1296777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432771200000",
    "number": "1508162710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5850 ROY HTS",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809181593",
            "telephone_number": "785-821-0499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 MAX DR",
            "address_2": "SUITE 101",
            "city": "CASTLE PINES",
            "state": "CO",
            "postal_code": "801089517",
            "telephone_number": "303-688-5066",
            "fax_number": "303-688-6986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNER",
        "first_name": "LACEY",
        "middle_name": "B",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-04",
        "last_updated": "2015-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "OEG002404",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "0002932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Bingham
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• Bluebird Sky Therapy
• Brandon Linn Orthodontics, PC
• Michaela Elizabeth Brezin, RN
• Samantha E Brown, PTA, CSCS
• Kristina Calabrese
• Canyon Ridge Integrative Health LLC
• Canyon Ridge Integrative Health LLC

• Optometrist in Castle Pines, CO
• Providers in Castle Pines, CO by specialty
• Optometrist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2015; 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.