BRADEN G. ANDERSON (NPI# 1497131072) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497131072 |
| Entity Type | Individual |
| Full Name | BRADEN G. ANDERSON |
| Credential | OD |
| Practice Address |
15 Founders Ln Jacksonville IL 62650-3919 |
| Mailing Address |
1025 S 6th St Springfield IL 62703-2403 |
| Practice Telephone | 2175287541 |
| Mailing Telephone | 2175287541 |
| Enumeration Date | 2015-08-05 |
| Last Update Date | 2020-05-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 046010944 | IL | Eye and Vision Services Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336776517 | Braden Anderson | Student in an Organized Health Care Education/Training Program | 2900 N Lake Shore Dr, Chicago, IL 60657-5640 | 2020-03-26 |
| 1548896525 | Braden Anderson | Student in an Organized Health Care Education/Training Program | Baylor Scott & White Medical Center-temple, 2401 South 31st Street, Ms 01 161b, Temple, TX 76508 | 2020-03-21 |
| Street Address |
15 FOUNDERS LN |
| City | JACKSONVILLE |
| State | IL |
| Zip Code | 62650-3919 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487609640 | Kim Wyatt | Family Medicine | 15 Founders Ln, Jacksonville, IL 62650-3919 | 2006-05-24 |
| 1144850769 | Melinda J Dorsey | Registered Nurse | 15 Founders Ln, Jacksonville, IL 62650-3919 | 2020-01-23 |
| 1578115390 | Doug R Mckain | Nurse Practitioner | 15 Founders Ln, Jacksonville, IL 62650 | 2019-07-11 |
| 1265901227 | Lisa J. Lyons | Physician Assistant | 15 Founders Ln, Jacksonville, IL 62650-3919 | 2018-11-20 |
| 1528518602 | Agnes A. Fenner | Nurse Practitioner | 15 Founders Ln, Jacksonville, IL 62650-3919 | 2016-10-12 |
| 1285184713 | Kaitlyn Renee Davidson | Nurse Practitioner | 15 Founders Ln, Jacksonville, IL 62650 | 2016-10-07 |
| 1538518709 | Natalie Mahoney | Family Medicine | 15 Founders Ln, Jacksonville, IL 62650-3919 | 2016-06-08 |
| 1194196493 | Molly Taylor | Nurse Practitioner | 15 Founders Ln, Suite 100, Jacksonville, IL 62650-3919 | 2015-10-13 |
| 1083020903 | Coral Jeanne Armour | Social Worker | 15 Founders Ln, Jacksonville, IL 62650-3919 | 2014-07-11 |
| 1326458332 | Mosam B Patel | Family Medicine | 15 Founders Ln, Jacksonville, IL 62650-3919 | 2014-04-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134768708 | Stephanie Lee Mabus | Occupational Therapy Assistant | 873 Gorve St, Jacksonville, IL 62650 | 2019-12-31 |
| 1285281071 | Sharshon Pharmacy Inc | Pharmacy | 154 W Morton Ave, Jacksonville, IL 62650 | 2019-08-26 |
| 1992275499 | Brittany Ruth Helmich | Counselor | 340 W. State St., Jacksonville, IL 62650 | 2018-11-28 |
| 1811391782 | Rodney E. Overstreet | Hearing Instrument Specialist | 1521 W. Walnut, Jacksonville, IL 62650 | 2014-10-21 |
| 1407979818 | Jan Ala | Speech-Language Pathologist | 1111 W Morton, Speechworks, Jacksonville, IL 62650 | 2007-04-09 |
| 1083787592 | Eldon G Barrowes Dds & Assoc PC | Dentist | 1515 West Walnut, Bldg #3, Jacksonville, IL 62650 | 2006-11-15 |
| 1194895979 | Joseph J Kozma | Internal Medicine | 1440 West Walnut, Jacksonville, IL 62650 | 2006-11-08 |
| 1740350529 | Susan Weller | Dentist | 1614 West Lafayette Avenue, Jackson, IL 62650 | 2006-11-08 |
| 1659467793 | Shawn M Fry | Family Medicine | 610 N. Westgate, Jacksonville, IL 62650 | 2006-10-05 |
| 1518050061 | Ward Richard Dunseth II | Nurse Anesthetist, Certified Registered | 1400 W Walnut, Jacksonville, IL 62650 | 2006-10-02 |
| Find all providers in zip 62650 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215553367 | Myeyedr Optometry of Florida, LLC | Optometrist | 2152 3rd St S # 60, Jacksonville, FL 32250-4019 | 2020-06-24 |
| 1154945814 | Kaitlin Jaquett Brown | Optometrist | 4788 Hodges Blvd Ste 205, Jacksonville, FL 32224-7223 | 2020-05-29 |
| 1831745660 | National Vision Inc | Optometrist | 14021 Lunar Drive, Unit 1, Jacksonville, FL 32218-7290 | 2019-08-16 |
| 1144876475 | Myeyedr Optometry of Florida, LLC | Optometrist | 11945 San Jose Blvd Ste 202, Jacksonville, FL 32223-1612 | 2019-08-13 |
| 1295294742 | Myeyedr Optometry of Florida, LLC | Optometrist | 13760 Old Saint Augustine Rd Ste 102, Jacksonville, FL 32258-5492 | 2019-03-14 |
| 1922578558 | Fatima Hussain Crofton | Optometrist | 7051 Southpoint Parkway S 300, Jacksonville, FL 32216 | 2018-11-27 |
| 1356820211 | Nisha Patel | Optometrist | 10300 Southside Blvd Ste 114, Jacksonville, FL 32256-6759 | 2018-08-11 |
| 1538650155 | Vision Today Pllc | Optometrist | 9365-2 Atlantic Blvd, Jacksonville, FL 32225-8203 | 2018-05-21 |
| 1447765748 | Sudduth Vision Pllc | Optometrist | 8000 Parramore Rd., Jacksonville, FL 32244 | 2017-12-08 |
| 1851806657 | Ann Huynh Nguyen | Optometrist | 9041 Southside Blvd Ste 174, Jacksonville, FL 32256-8482 | 2017-12-04 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 62650 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.