Individual provider Active NPI

Bradley Linder

  • Optician
  • Sheboygan, WI
National Provider Identifier
1629420526
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
Practice address
1442 N 31St St
Sheboygan, WI 53081-3061
Phone
(920) 452-5400
NPI assigned
Jul 5, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X Primary

Addresses

Primary practice location

1442 N 31St St
Sheboygan, WI 53081-3061

Mailing address

1442 N 31St St
Sheboygan, WI 53081-3061
Phone (920) 918-3674

Other practice location 1

409 S 8th St Ste 101
Boise, ID 83702-7136
Phone (208) 344-1390

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

OrganizationSpecialtyStatusNew patients
Sheboygan Optical Co. LLC Current Accepting new patients
Larson Eye Care SC Current Accepting new patients

Locations

1442 N 31st St
Sheboygan, WI 53081
Phone (920) 452-1810

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1467676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1629420526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1442 N 31ST ST",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530813061",
            "telephone_number": "920-918-3674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1442 N 31ST ST",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530813061",
            "telephone_number": "920-452-5400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "409 S 8th St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837027136",
            "country_code": "US",
            "telephone_number": "208-344-1390",
            "fax_number": "208-344-1391",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LINDER",
        "first_name": "BRADLEY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-05",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheboygan, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.