Brooke Bush

Primary specialty

OptometristTaxonomy code 152W00000X

License

3123 Issued in MN

Legal business name

BROOKE BUSH

Practice address

18275 Kenrick Ave
Lakeville, MN 55044-7306

Phone

(507) 884-9474

NPI assigned

Jun 22, 2016

Organization subpart

No

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

Authorized official

Name

Brooke Bush

Title

Optometrist

Phone

(507) 884-9474

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1466553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466553600000",
    "number": "1679924419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 211702",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551213702",
            "telephone_number": "507-884-9474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18275 KENRICK AVE",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550447306",
            "telephone_number": "507-884-9474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKE BUSH",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-22",
        "last_updated": "2016-06-22",
        "status": "A",
        "authorized_official_last_name": "BUSH",
        "authorized_official_first_name": "BROOKE",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "507-884-9474"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bridgeway Care Services LLC
• Bright Futures Residence LLC
• Brightline Wellness LLC
• Emily Bristlin, BCBA
• Nicole Broden, OD
• Laura Brown, MA, LPCC
• Rebecca May Brown, M.A.
• Simpson Brown
• Rebecca Diane Brubaker, CFP
• Sophia Brunstad

• Optometrist in Lakeville, MN
• Providers in Lakeville, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2016; 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.