Active NPI
Brian K Boddy
- Optician
- Santa Fe, NM
National Provider Identifier
1609019405
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- Practice address
- 3530 Zafarano Dr Ste C1
Santa Fe, NM 87507-2609 - Phone
- (505) 471-2020
- Fax
- (505) 473-5103
- NPI assigned
- Apr 9, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | Primary |
Addresses
Primary practice location
3530 Zafarano Dr Ste C1
Santa Fe, NM 87507-2609
Mailing address
PO Box 6079
Santa Fe, NM 87502-6079
Phone (505) 471-2020
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| David Vise OD, LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Medical Specialty Clinic/Center
- Santa Fe, NM
- NPI 1346685658
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1239235200000",
"number": "1609019405",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6079",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875026079",
"telephone_number": "505-471-2020",
"fax_number": "505-473-5103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3530 ZAFARANO DR STE C1",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875072609",
"telephone_number": "505-471-2020",
"fax_number": "505-473-5103"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BODDY",
"first_name": "BRIAN",
"middle_name": "K",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-04-09",
"last_updated": "2009-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Fe, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.