Organization Active NPI

Bruce G. Barry

  • Optometrist
  • Stoughton, WI
National Provider Identifier
1942400619
Registry record updated Dec 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
BRUCE G. BARRY
Practice address
105 Kings Lynn Rd
Stoughton, WI 53589-1999
Phone
(608) 873-2020
NPI assigned
Jul 20, 2007
Last updated
Dec 8, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2008

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

Authorized official

Name
Bruce Barry, ODNPI 1407908254
Title
Owner
Phone
(608) 873-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

105 Kings Lynn Rd
Stoughton, WI 53589-1999

Mailing address

105 Kings Lynn Rd
Stoughton, WI 53589
Phone (608) 873-2020

Other identifiers 1

IdentifierTypeStateIssuer
38709100MedicaidWI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1184889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228694400000",
    "number": "1942400619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 KINGS LYNN RD",
            "city": "STOUGHTON",
            "state": "WI",
            "postal_code": "53589",
            "telephone_number": "608-873-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 KINGS LYNN RD",
            "city": "STOUGHTON",
            "state": "WI",
            "postal_code": "535891999",
            "telephone_number": "608-873-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUCE G. BARRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-20",
        "last_updated": "2008-12-08",
        "status": "A",
        "authorized_official_last_name": "BARRY",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "608-873-2020",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38709100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stoughton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 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.