Active NPI
Dr Robert D Head and Dr Jennifer L Head LLC
- Optometrist
- Lawton, OK
National Provider Identifier
1043426901
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1049
- Legal business name
- DR ROBERT D HEAD AND DR JENNIFER L HEAD LLC
- Practice address
- 1302 SW C Ave
Lawton, OK 73501-4243 - Phone
- (580) 355-1298
- Fax
- (580) 581-7201
- NPI assigned
- May 15, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Brenda Brewster
- Title
- Office Manager
- Phone
- (580) 355-1298
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1049 | OK | Primary |
Addresses
Primary practice location
1302 SW C Ave
Lawton, OK 73501-4243
Mailing address
1302 SW C Ave
Lawton, OK 73501-4243
Phone (580) 355-1298
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100763770A | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
Enrollment records 2
National Provider Directory
National Provider Directory- Tax ID family
- Dr Robert D Head and Dr Jennifer L Head LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Optometrist
- Lawton, OK
- NPI 1730498890
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Low Vision Rehabilitation Optometrist
- Lawton, OK
- NPI 1952430480
-
- Optometrist
- Lawton, OK
- NPI 1386970895
-
- Optometrist
- Lawton, OK
- NPI 1356470975
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179187200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1331164800000",
"number": "1043426901",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1302 SW C AVE",
"city": "LAWTON",
"state": "OK",
"postal_code": "735014243",
"telephone_number": "580-355-1298",
"fax_number": "580-581-7201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1302 SW C AVE",
"city": "LAWTON",
"state": "OK",
"postal_code": "735014243",
"telephone_number": "580-355-1298",
"fax_number": "580-581-7201"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DR ROBERT D HEAD AND DR JENNIFER L HEAD LLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-05-15",
"last_updated": "2012-03-08",
"status": "A",
"authorized_official_last_name": "BREWSTER",
"authorized_official_first_name": "BRENDA",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "580-355-1298"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Optometrist",
"state": "OK",
"license": "1049",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100763770A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lawton, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2012; 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.