William F. Brigham, OD

Primary specialty

Vision Therapy OptometristTaxonomy code 152WV0400X

License

18001470A Issued in IN

Practice address

902 W Wayne St
Fort Wayne, IN 46802-3946

Phone

(260) 422-9421

Fax

(260) 422-9422

NPI assigned

Nov 21, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Michelle L. Frye, O.D. LLC

  • Clinic/Center
  • Fort Wayne, IN
  • NPI 1437517968
  NPD (past)

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215648000000",
    "number": "1750364006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 W WAYNE ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468023976",
            "telephone_number": "260-422-9421",
            "fax_number": "260-422-9422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 W WAYNE ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468023946",
            "telephone_number": "260-422-9421",
            "fax_number": "260-422-9422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIGHAM",
        "first_name": "WILLIAM",
        "middle_name": "F.",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-21",
        "last_updated": "2008-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "IN",
            "license": "18001470A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100280170A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Vision Therapy Optometrist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Vision Therapy Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.

Verify at the official NPI Registry.