Dr Paul Brinckman OD LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

DR PAUL BRINCKMAN OD LLC

Practice address

16124 W 135TH St
Olathe, KS 66062-1517

Phone

(913) 764-3937

NPI assigned

Sep 12, 2017

Organization subpart

No

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

Authorized official

Name

Paul Brinckman, OD

Title

Owner

Phone

(913) 707-5126

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1505174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538611200000",
    "number": "1912426917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11063 S MEMORIAL DR STE D",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741337366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16124 W 135TH ST",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660621517",
            "telephone_number": "913-764-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR PAUL BRINCKMAN OD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-12",
        "last_updated": "2018-10-04",
        "status": "A",
        "authorized_official_last_name": "BRINCKMAN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "913-707-5126",
        "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": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2018; 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.