Kyle a. Brodie, O.D., Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

KYLE A. BRODIE, O.D., INC.

Practice address

107 S Walnut St
Woodville, OH 43469-1333

Phone

(419) 849-3811

Fax

(567) 482-4006

NPI assigned

Jan 14, 2008

Last updated

Dec 29, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kyle A. Brodie, O.D.NPI 1962580217

Title

Owner

Phone

(419) 931-2020

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kyle A Brodie, O.D.

  • Optometrist
  • Perrysburg, OH
  • NPI 1962580217
  Medicare reassignment Authorized official
• Dennis R Laub, O.D.

  • Optometrist
  • Woodville, OH
  • NPI 1124197868
  NPD (past)
• Teresa Marie Rohrs, O.D.

  • Optometrist
  • Ottawa, OH
  • NPI 1437291945
  NPD (past)
• Elizabeth C Wargo, OTR

  • Occupational Therapist
  • Perrysburg, OH
  • NPI 1215118146
  NPD (past)

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

{
    "created_epoch": "1200268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703808000000",
    "number": "1679759229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 S WALNUT ST",
            "city": "WOODVILLE",
            "state": "OH",
            "postal_code": "434691333",
            "telephone_number": "419-849-3811",
            "fax_number": "567-482-4006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 S WALNUT ST",
            "city": "WOODVILLE",
            "state": "OH",
            "postal_code": "434691333",
            "telephone_number": "419-849-3811",
            "fax_number": "567-482-4006"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "840 W. Boundary Street, Suite 1",
            "address_purpose": "LOCATION",
            "city": "Perrysburg",
            "state": "OH",
            "postal_code": "43551",
            "country_code": "US",
            "telephone_number": "419-931-2020",
            "fax_number": "419-873-1445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KYLE A. BRODIE, O.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-14",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A",
        "authorized_official_last_name": "BRODIE",
        "authorized_official_first_name": "KYLE",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "419-931-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2049232",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hayder Al Janabi DMD Family Dentistry LLC (Woodville Dental Care)
• Heather Ann Haynes, M.D.
• Jonathan P Hegemier, PT
• Rebecca Jones
• Elizabeth Kramer
• Dennis R Laub, O.D.
• Jeanne Lynn Less, LPN
• Kathleen Lowery, RPH
• Elizabeth Ann Lucas
• Linda Meyer

• Optometrist in Woodville, OH
• Providers in Woodville, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.