Bsgi Holdings LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

BSGI HOLDINGS LLC

Practice address

2102 N Prospect Ave
Champaign, IL 61822-1231

Phone

(217) 352-2468

NPI assigned

Aug 4, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Bradley Grant, ODNPI 1386836518

Title

Member

Phone

(901) 496-9129

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bradley Stewart Grant, O.D.

  • Optometrist
  • Bloomington, IL
  • NPI 1386836518
  NPD Authorized official

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

{
    "created_epoch": "1628035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628035200000",
    "number": "1891469698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 BUCKS POND RD",
            "city": "MONTICELLO",
            "state": "IL",
            "postal_code": "618568058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2102 N PROSPECT AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618221231",
            "telephone_number": "217-352-2468"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3445 Freedom Dr",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627046517",
            "country_code": "US",
            "telephone_number": "217-546-0639",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BSGI HOLDINGS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-04",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A",
        "authorized_official_last_name": "GRANT",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "901-496-9129",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vaughn Bruno, RBT
• Jeffrey Todd Brunson, DDS
• Bryan Manion, Life Coach
• Wilma L Bryant, LCSW
• Katherine Elaine Bryson, L.P.N.
• Lacey Deyanne Buckhannon
• Christopher Buckner, BSW
• Eunice Marie Bucknerboone, MS,LCPC,LPHA
• Hayley Buesing, LSW
• Michael Bufford

• Optometrist in Champaign, IL
• Providers in Champaign, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2021; 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.