NPIMap

Organization Active NPI

Brent W Fidler

  • Optometrist
  • Loveland, CO
National Provider Identifier
1568636207
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
BRENT W FIDLER
Doing business as
Eisenhower Eyecare
Practice address
1524 W Eisenhower Blvd
Ste. C
Loveland, CO 80537-3112
Phone
(970) 667-2954
Fax
(970) 663-4713
NPI assigned
Apr 14, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

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

Authorized official

Name
Dr. Brent W. Fidler, O.D.
Title
Owner
Phone
(970) 667-2954

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

1524 W Eisenhower Blvd
Ste. C
Loveland, CO 80537-3112

Mailing address

1524 W Eisenhower Blvd
Ste. C
Loveland, CO 80537-3112
Phone (970) 667-2954

Other names 1

  • Eisenhower Eyecare Doing business as

National Provider Directory

National Provider Directory

Locations

1524 W Eisenhower Blvd
Ste C
Loveland, CO 80537
Phone (970) 667-2954

1524 W Eisenhower Blvd
Loveland, CO 80537
Phone (970) 667-2954

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

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": "1208131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214352000000",
    "number": "1568636207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1524 W EISENHOWER BLVD",
            "address_2": "STE. C",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805373112",
            "telephone_number": "970-667-2954",
            "fax_number": "970-663-4713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1524 W EISENHOWER BLVD",
            "address_2": "STE. C",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805373112",
            "telephone_number": "970-667-2954",
            "fax_number": "970-663-4713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRENT W FIDLER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-14",
        "last_updated": "2008-06-25",
        "status": "A",
        "authorized_official_last_name": "FIDLER",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-667-2954",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eisenhower Eyecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Loveland, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.