Edmond Optical Shop, Inc.

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

EDMOND OPTICAL SHOP, INC.

Practice address

920 S Bryant Ave
Suite 101
Edmond, OK 73034-5797

Phone

(405) 341-6588

Fax

(405) 348-9537

NPI assigned

May 16, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Lonnie B. Masters

Title

Owneroptician

Phone

(405) 341-6588

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Cody Benton Masters, OPTICIAN

  • Optician
  • Edmond, OK
  • NPI 1952633372
  NPD

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274313600000",
    "number": "1003022773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 S BRYANT AVE",
            "address_2": "SUITE 101",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730345797",
            "telephone_number": "405-341-6588",
            "fax_number": "405-348-9537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 S BRYANT AVE",
            "address_2": "SUITE 101",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730345797",
            "telephone_number": "405-341-6588",
            "fax_number": "405-348-9537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDMOND OPTICAL SHOP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2010-05-20",
        "status": "A",
        "authorized_official_last_name": "MASTERS",
        "authorized_official_first_name": "LONNIE",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "OWNEROPTICIAN",
        "authorized_official_telephone_number": "405-341-6588",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edmond Hospitalists LLC
• Edmond Hyperbarics, Inc.
• Edmond Laser Institute L.L.C.
• Edmond Memory Care, LLC
• Edmond MRI LLC
• Edmond Oral and Maxillofacial Surgery
• Edmond Pediatric and Teen Dentistry
• Edmond Pediatrics
• Edmond Physician Services LLC
• Edmond Podiatry Associates LLC

• Eyewear Supplier in Edmond, OK
• Providers in Edmond, OK by specialty
• Eyewear Supplier in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.