Individual provider Active NPI

Jessica Greene, O.D.

  • Optometrist
  • Elk City, OK
National Provider Identifier
1083067490
Registry record updated Jul 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2888 Issued in OK
Practice address
800 N Main St
Elk City, OK 73644-3414
Phone
(580) 225-1980
NPI assigned
Jul 20, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2888 OK Primary

Addresses

Primary practice location

800 N Main St
Elk City, OK 73644-3414

Mailing address

800 N Main St
Elk City, OK 73644-3414
Phone (580) 225-1980

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 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
I20161005000291 OK Practitioner - Optometry 1456649532 Reassigns benefits to 1 organization
I20251010000126 TX Practitioner - Optometry 1456649532 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clinton Indian Health Center 74 clinicians
Watonga Indian Health Center 7 clinicians
Eyecare of Western Oklahoma PC 2 clinicians

Practice addresses (Care Compare)

10321 N
Suite 2274
Clinton, OK 73601-7521

10321 N 2274 Rd
Clinton, OK 73601-7521
Phone (580) 331-3410

1305 S Clarence Nash Blvd
Watonga, OK 73772-4820
Phone (580) 632-4991

800 N Main St
Elk City, OK 73644-3414
Phone (580) 225-1980

Hospital & facility affiliations

  • Lawton Indian Hospital Hospital, Lawton, OK, CCN 370170

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2888OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
El Reno Indian Health Center CurrentSince Aug 24, 2025 Accepting new patients
Watonga Indian Health Center CurrentSince Aug 24, 2025 Accepting new patients
Eyecare of Western Oklahoma PC Optometrist CurrentSince Aug 31, 2016 Accepting new patients
Clinton Indian Health Center CurrentSince Aug 24, 2025 Accepting new patients

Locations

10321 N 2274 Rd
Clinton, OK 73601
Phone (580) 331-3300

1801 Parkview Dr
El Reno, OK 73036
Phone (405) 234-5600

800 N Main St
Elk City, OK 73644
Phone (580) 225-1978

1305 S Clarence Nash Blvd
Watonga, OK 73772
Phone (580) 623-4991

Organizations & group practices 4

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 6

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": "1468972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468972800000",
    "number": "1083067490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 N MAIN ST",
            "city": "ELK CITY",
            "state": "OK",
            "postal_code": "736443414",
            "telephone_number": "580-225-1980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N MAIN ST",
            "city": "ELK CITY",
            "state": "OK",
            "postal_code": "736443414",
            "telephone_number": "580-225-1980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "JESSICA",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-20",
        "last_updated": "2016-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk City, OK

Sources for this page

Verify at the official NPI Registry.