NPIMap

Organization Active NPI

Brubaker Vision

  • Optometrist
  • Apple Valley, MN
National Provider Identifier
1982071825
Registry record updated Aug 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2514 Issued in MN
Legal business name
BRUBAKER VISION
Practice address
7835 150TH St W
Apple Valley, MN 55124-7181
Phone
(952) 431-9709
NPI assigned
Aug 26, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2015

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

Authorized official

Name
Dr. Elliott D Brubaker, O.D.
Title
President/Optometrist
Phone
(612) 240-3814

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 2514 MN Primary

Addresses

Primary practice location

7835 150TH St W
Apple Valley, MN 55124-7181

Mailing address

11712 Galtier Dr
Burnsville, MN 55337-3208

National Provider Directory

National Provider Directory
Tax ID family
Brubaker Vision2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1440547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440547200000",
    "number": "1982071825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11712 GALTIER DR",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553373208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7835 150TH ST W",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551247181",
            "telephone_number": "952-431-9709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUBAKER VISION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-26",
        "last_updated": "2015-08-26",
        "status": "A",
        "authorized_official_last_name": "BRUBAKER",
        "authorized_official_first_name": "ELLIOTT",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT/OPTOMETRIST",
        "authorized_official_telephone_number": "612-240-3814",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apple Valley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2015; 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.