NPI age
18 years
Enumerated 2007-08-20
● Active
Type 1 · Individual
Lee Brock Wren, OD
Wren is 1 of 10 optometrist providers in Blackfoot and 1 of 598 in Idaho.
Primary specialty
Optometrist
Plus 1 subspecialty
Licensed in
ID, UT
2 states
Status
Active
No deactivations on record
Last NPPES update
2019-09-10
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 598 active optometrist providers in Idaho.
NPI age
18 years
≈ at median (18 yr)
State licenses
2 states
Top 88% — 11% of peers are multi-state
Subspecialties
0
17% of peers hold subspecialties
NPI lifetime · 2007 → 2026
2007-08Enumerated in NPPES
2007
2026
Where they practice
Practice location
715 W Judicial St
Blackfoot, ID 832212036
Mailing address
715 W Judicial St
Blackfoot, ID 832212036
Specialties
-
Optometrist PrimaryDoctors 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...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 1215120696 | |
| 01 (UT) | 66612099900001 | BLUE CROSS/BLUE SHIELD |
| 05 (UT) | 999000797009 |
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.