Individual provider Active NPI

Jordan Heath Fleming, OD

  • Optometrist
  • Shawnee, OK
National Provider Identifier
1003489527
Registry record updated Jul 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3124 Issued in OK
Practice address
2307 Gordon Cooper Dr
Shawnee, OK 74801-9007
Phone
(405) 273-5236
Fax
(405) 878-4835
NPI assigned
Jul 22, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 3124 OK Primary

Addresses

Primary practice location

2307 Gordon Cooper Dr
Shawnee, OK 74801-9007

Mailing address

2307 Gordon Cooper Dr
Shawnee, OK 74801-9007
Phone (405) 273-5236

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, OK2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211025000595 TX Practitioner - Optometry 0042608028 Reassigns benefits to 2 organizations
I20230228002433 OK Practitioner - Optometry 0042608028 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cherokee NationGroup PAC ID 5799698742, 446 clinicians

Practice addresses (Care Compare)

27371 S 4410 Rd
Vinita, OK 74301-7953
Phone (918) 256-4800

Hospital & facility affiliations

  • Cherokee Nation W W Hastings Indian Hospital Hospital, Tahlequah, OK, CCN 370171

Merit-based Incentive Payment System (MIPS)

Final score
85.4 of 100Reported as group
Quality
72.78
Promoting interoperability
98
Improvement activities
40
Cost
76.77

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3124OKMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Citizen Potawatomi Nation Single Specialty Current Accepting new patients
Cherokee Nation Single Specialty CurrentSince Jan 27, 2023 Accepting new patients
Citizen Potawatomi Nation Single Specialty CurrentSince Sep 1, 2021 Accepting new patients
Cherokee Nation Single Specialty Current Accepting new patients
Citizen Potawatomi Nation Single Specialty CurrentSince Sep 1, 2021 Accepting new patients
Cherokee Nation CurrentSince Jan 27, 2023 Accepting new patients
Northeastern State University College of Optometry Optometrist CurrentSince Feb 1, 2023 Accepting new patients
Cherokee Nation Single Specialty Current Accepting new patients
Cherokee Nation Single Specialty Current Accepting new patients
Cherokee Nation Single Specialty Current Accepting new patients
Vinita Family Eyecare, PLLC Optometrist CurrentSince Aug 1, 2025 Accepting new patients

Locations

859 E Melton Dr
Jay, OK 74346
Phone (918) 253-4271

1001 S 41st St E
#3
Muskogee, OK 74403
Phone (918) 687-0201

1020 Lenape Dr
Nowata, OK 74048
Phone (918) 273-0192

900 N Owen Walters Blvd
Salina, OK 74365
Phone (918) 434-8500

781 Grand Casino Blvd
Shawnee, OK 74804
Phone (405) 964-4025

2307 Gordon Cooper Dr
Shawnee, OK 74801
Phone (405) 273-5236

870 E Crafton St
Tahlequah, OK 74464
Phone (918) 444-4000

100 S Bliss Ave
Tahlequah, OK 74464
Phone (918) 458-3100

19600 E Ross St
Tahlequah, OK 74464
Phone (539) 234-1000

Dept 2269
Tulsa, OK 74182

529 N Wilson St
Vinita, OK 74301
Phone (918) 256-5543

27371 S 4410 Rd
Vinita, OK 74301
Phone (918) 256-4800

Interoperability endpoints

  • FHIR API: https://epicproxy.et1447.epichosted.com/APIProxyPRD/api/FHIR/R4

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1626912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1003489527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2307 GORDON COOPER DR",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748019007",
            "telephone_number": "405-273-5236",
            "fax_number": "405-878-4835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2307 GORDON COOPER DR",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748019007",
            "telephone_number": "405-273-5236",
            "fax_number": "405-878-4835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLEMING",
        "first_name": "JORDAN",
        "middle_name": "HEATH",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-22",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OK",
            "license": "3124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee, OK

Sources for this page

Verify at the official NPI Registry.