Active NPI
Boucher'S Opticians of Brockton, Inc.
- Optician
- Brockton, MA
National Provider Identifier
1659543882
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 1615
- Legal business name
- BOUCHER'S OPTICIANS OF BROCKTON, INC.
- Practice address
- 727 Belmont Street
Brockton, MA 02301-5666 - Phone
- (508) 586-2725
- Fax
- (508) 586-2770
- NPI assigned
- Mar 27, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Timothy Marshall Foote, REGISTERED DISPENSIN
- Title
- Owner/President
- Phone
- (508) 586-2725
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 1615 | MA | Primary |
Addresses
Primary practice location
727 Belmont Street
Brockton, MA 02301-5666
Mailing address
727 Belmont Street
Brockton, MA 02301-5666
Phone (508) 586-2725
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1506773 | Other | MA | MASSHEALTH PROVIDER |
| 03306908387 | Other | MA | MASSHEALTH TRADING PARTNE |
National Provider Directory
National Provider DirectoryLocations
727 Belmont St
Brockton, MA 02301
Phone (508) 586-2725
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Optician
- Brockton, MA
- NPI 1407060361
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206576000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1222214400000",
"number": "1659543882",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "727 BELMONT STREET",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023015666",
"telephone_number": "508-586-2725",
"fax_number": "508-586-2770"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "727 BELMONT STREET",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023015666",
"telephone_number": "508-586-2725",
"fax_number": "508-586-2770"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BOUCHER'S OPTICIANS OF BROCKTON, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2008-03-27",
"last_updated": "2008-09-24",
"status": "A",
"authorized_official_last_name": "FOOTE",
"authorized_official_first_name": "TIMOTHY",
"authorized_official_middle_name": "MARSHALL",
"authorized_official_title_or_position": "OWNER/PRESIDENT",
"authorized_official_telephone_number": "508-586-2725",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "REGISTERED DISPENSIN"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Technician/Technologist, Optician",
"state": "MA",
"license": "1615",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MASSHEALTH PROVIDER",
"identifier": "1506773",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MASSHEALTH TRADING PARTNE",
"identifier": "03306908387",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brockton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.