Provider Demographics
NPI:1548326309
Name:SCHOPPE, BRENT JAMES (OD)
Entity type:Individual
Prefix:DR
First Name:BRENT
Middle Name:JAMES
Last Name:SCHOPPE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3860 MONROE RD
Mailing Address - Street 2:
Mailing Address - City:DE PERE
Mailing Address - State:WI
Mailing Address - Zip Code:54115-8399
Mailing Address - Country:US
Mailing Address - Phone:920-496-4700
Mailing Address - Fax:
Practice Address - Street 1:3860 MONROE RD
Practice Address - Street 2:
Practice Address - City:DE PERE
Practice Address - State:WI
Practice Address - Zip Code:54115-8399
Practice Address - Country:US
Practice Address - Phone:920-496-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1595152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL363825038OtherVISION SERVICE PLAN
ILIL7813002OtherMEDICARE
AZZ172089OtherMEDICARE
IL363825038OtherALWAYSCARE BENEFITS, INC.
IL363825038OtherCIGNA HEALTH CARE
AZZ172088OtherMEDICARE
IL998900003OtherMEDICARE
ILIL9547OtherEYEMED VISION CARE
AZZ172093OtherMEDICARE
AZ925255Medicaid
AZZ172091OtherMEDICARE
AZZ172092OtherMEDICARE
AZZ172090OtherMEDICARE
IL0007384654OtherAETNA
ILK12740OtherMEDICARE