Active NPI
Brian William Grover, O.S.
- Optician
- Stratford, CT
National Provider Identifier
1760616478
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 001123
- Practice address
- 2505 Main St
Stratford, CT 06615-5839 - Phone
- (203) 378-2281
- Fax
- (203) 377-0233
- NPI assigned
- May 8, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 001123 | CT | Primary |
Addresses
Primary practice location
2505 Main St
Stratford, CT 06615-5839
Mailing address
2505 Main St
Stratford, CT 06615-5839
Phone (203) 378-2281
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001123 | CT | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1241740800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1244678400000",
"number": "1760616478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2505 MAIN ST",
"city": "STRATFORD",
"state": "CT",
"postal_code": "066155839",
"telephone_number": "203-378-2281",
"fax_number": "203-377-0233"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2505 MAIN ST",
"city": "STRATFORD",
"state": "CT",
"postal_code": "066155839",
"telephone_number": "203-378-2281",
"fax_number": "203-377-0233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROVER",
"first_name": "BRIAN",
"middle_name": "WILLIAM",
"name_prefix": "Mr.",
"credential": "O.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-05-08",
"last_updated": "2009-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "CT",
"license": "001123",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stratford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.