Active NPI
Riyad Khamis, O.D
- Optometrist
- Tahlequah, OK
National Provider Identifier
1063865624
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2890
- Practice address
- 1001 N Grand Ave
Tahlequah, OK 74464-7017 - Phone
- (918) 822-1299
- NPI assigned
- Jul 19, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2890 | OK | Primary |
Addresses
Primary practice location
1001 N Grand Ave
Tahlequah, OK 74464-7017
Mailing address
1512 N Kennedy LN
Tahlequah, OK 74464-4454
Phone (918) 822-1299
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2890 | OK | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468972800000",
"number": "1063865624",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1512 N KENNEDY LN",
"city": "TAHLEQUAH",
"state": "OK",
"postal_code": "744644454",
"telephone_number": "918-822-1299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 N GRAND AVE",
"city": "TAHLEQUAH",
"state": "OK",
"postal_code": "744647017",
"telephone_number": "918-822-1299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHAMIS",
"first_name": "RIYAD",
"name_prefix": "Dr.",
"credential": "O.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-07-19",
"last_updated": "2016-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OK",
"license": "2890",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tahlequah, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.