Elliott Vision Care, PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

2241 Issued in OK

Legal business name

ELLIOTT VISION CARE, PLLC

Practice address

1139 N Hills Ctr
Ada, OK 74820-1882

Phone

(580) 332-6000

Fax

(580) 332-6006

NPI assigned

Feb 17, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Jeffery Dale Elliott, ODNPI 1780766592

Title

Owner

Phone

(580) 272-8253

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK2 enrollments

Enrollment records 2

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.

• Jeffery Dale Elliott, O.D.

  • Optometrist
  • Ada, OK
  • NPI 1780766592
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1455667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642377600000",
    "number": "1023477106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1139 N HILLS CTR",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748201882",
            "telephone_number": "580-332-6000",
            "fax_number": "580-332-6006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1139 N HILLS CTR",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748201882",
            "telephone_number": "580-332-6000",
            "fax_number": "580-332-6006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLIOTT VISION CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-17",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-17",
        "status": "A",
        "authorized_official_last_name": "ELLIOTT",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "580-272-8253",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsey Edwards, RDH
• Lori Dorcel Edwards, M.S.
• Kayla Effinger
• Derick Allen Eidson
• Melissa Eidson
• Jeffery Dale Elliott, O.D.
• Tarin Elliott, DPT
• Andrew Ellis
• Melanie Faye Ellison
• Jamison Elston, PTA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2022; 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.