NPIMap

Organization Active NPI

Glenn P Hoot MD PHD PS Inc

Doing business as DBA Broadway Optical

  • Durable Medical Equipment & Medical Supplies
  • Aberdeen, WA
National Provider Identifier
1780866053
Registry record updated Nov 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
MD32157 Issued in WA
Legal business name
GLENN P HOOT MD PHD PS INC
Doing business as
DBA Broadway Optical
Practice address
118 W 1St St
Aberdeen, WA 98520-6215
Phone
(360) 532-3773
Fax
(360) 533-6545
NPI assigned
Nov 28, 2007
Last updated
Nov 28, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2007

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

Authorized official

Name
Dr. Glenn P Hoot, MD PH.D
Title
President
Phone
(360) 533-5800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X MD32157 WA Primary

Addresses

Primary practice location

118 W 1St St
Aberdeen, WA 98520-6215

Mailing address

118 W 1St St
Aberdeen, WA 98520-6215
Phone (360) 532-3773

Other names 1

  • DBA Broadway Optical Doing business as

National Provider Directory

National Provider Directory

Locations

118 W 1st St
Aberdeen, WA 98520
Phone (360) 532-3773

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196208000000",
    "number": "1780866053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 W 1ST ST",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "985206215",
            "telephone_number": "360-532-3773",
            "fax_number": "360-533-6545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 W 1ST ST",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "985206215",
            "telephone_number": "360-532-3773",
            "fax_number": "360-533-6545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENN P HOOT MD PHD PS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-28",
        "last_updated": "2007-11-28",
        "status": "A",
        "authorized_official_last_name": "HOOT",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-533-5800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD PH.D"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "WA",
            "license": "MD32157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DBA Broadway Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Aberdeen, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; 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.