Brand New Day, LLC
Organization Active NPI Optometrist · Lowell, IN
NPI 1619604337 · NPPES record last updated Aug 3, 2022
Key facts
- NPI
- 1619604337
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- Legal business name
- BRAND NEW DAY, LLC
- Practice address
- 313 E Commercial Ave Unit C
Lowell, IN 46356-1707 - Phone
- (410) 271-6747
- NPI assigned
- Aug 3, 2022
- Organization subpart
- No
Authorized official
- Name
- Dr. Kevin Eugene Johnson, OD
- Title
- Owner
- Phone
- (410) 271-6747
Practitioners 2
-
Kevin Johnson, OD
-
Lisa Marie Politza, O.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230203002388 | IN | Part B Supplier - Clinic/Group Practice | 4284006016 |
Receives reassigned benefits from 1 practitioner Practice locations: Lowell, IN |
National Provider Directory
Locations
313 E Commercial Ave
#C
Lowell, IN 46356
Phone (410) 271-6747
11028 96th Pl Ave
Saint John, IN 46373
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | Yes |
Addresses
Primary practice location
313 E Commercial Ave Unit C
Lowell, IN 46356-1707
Mailing address
313 E Commercial Ave Unit C
Lowell, IN 46356-1707
Phone (410) 271-6747
Other providers in Lowell, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 3, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.