Young Eye Clinic LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

2117 Issued in OK

Legal business name

YOUNG EYE CLINIC LLC

Practice address

12325 N Rockwell Ave
Oklahoma City, OK 73142-2702

Phone

(405) 728-3393

NPI assigned

Dec 6, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Gary Patrick Young, ODNPI 1427109099

Title

Doctor / Owner

Phone

(405) 728-3393

Specialties & licenses 4

Addresses

Other identifiers 3

Other names 1

• Young Eye Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

Practitioners 1

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

• Gary Patrick Young, O.D.

  • Optometrist
  • Oklahoma City, OK
  • NPI 1427109099
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1512518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1013422401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12325 N ROCKWELL AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731422702",
            "telephone_number": "405-728-3393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12325 N ROCKWELL AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731422702",
            "telephone_number": "405-728-3393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUNG EYE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-06",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "DOCTOR / OWNER",
        "authorized_official_telephone_number": "405-728-3393",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2117",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "OK",
            "license": "2117",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Sports Vision",
            "state": "OK",
            "license": "2117",
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist, Occupational Vision",
            "state": "OK",
            "license": "2117",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "918288",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100760340A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VISION SERVICE PLAN",
            "identifier": "4057283393",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Young Eye Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Cara Young

• Optometrist in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Optometrist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.