Patrick Niebrugge OD

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

0706010001 Issued in IN

Legal business name

PATRICK NIEBRUGGE OD

Practice address

1279 E US Hwy 40
Casey, IL 62420-0528

Phone

(217) 932-2310

Fax

(217) 932-4674

NPI assigned

Sep 5, 2007

Last updated

Feb 21, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Patrick M Niebrugge, ODNPI 1831228600

Title

Optometrist

Phone

(217) 932-2310

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

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.

• Patrick M Niebrugge, OPTOMETRIST OD

  • Optometrist
  • Casey, IL
  • NPI 1831228600
  Authorized official Same address or phone

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

{
    "created_epoch": "1188950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203552000000",
    "number": "1962696617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 528",
            "address_2": "1279 E US HWY 40",
            "city": "CASEY",
            "state": "IL",
            "postal_code": "624200528",
            "telephone_number": "217-932-2310",
            "fax_number": "217-932-4674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1279 E US HWY 40",
            "city": "CASEY",
            "state": "IL",
            "postal_code": "624200528",
            "telephone_number": "217-932-2310",
            "fax_number": "217-932-4674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICK NIEBRUGGE OD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-05",
        "last_updated": "2008-02-21",
        "status": "A",
        "authorized_official_last_name": "NIEBRUGGE",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "217-932-2310",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IN",
            "license": "0706010001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046007315",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1831228600",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Linda Mason, PTA
• Millikan Pharmacy
• Moore Family Stores Inc. (The Pharmacie Shoppe)
• Patrick M Niebrugge, OPTOMETRIST OD
• Kari Beth Packer, OTR/L
• Petersen Health Resources, LLC (Simple Blessings)
• Sarah Elizabeth Pfleging Vester, M.S.,CCC-SLP/L
• Restoration Dental LLC-Casey Family Dental (Casey Family Dental)
• Bobbie Seaney, LPN
• Stinson Chiropractic LLC

• Durable Medical Equipment & Medical Supplies in Casey, IL
• Providers in Casey, IL by specialty
• Durable Medical Equipment & Medical Supplies in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 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.