Individual provider Active NPI

Tara Dawn Brown, O.D.

  • Optometrist
  • Oklahoma City, OK
National Provider Identifier
1093824195
Registry record updated Apr 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1074 Issued in OK
Practice address
2915 Pine Ridge Rd
Oklahoma City, OK 73120-6111
Phone
(405) 752-6515
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1074 OK Primary
Optometrist 152W00000X 6680T TX

Addresses

Primary practice location

2915 Pine Ridge Rd
Oklahoma City, OK 73120-6111

Mailing address

2915 Pine Ridge Rd
Oklahoma City, OK 73120-6111
Phone (405) 752-6515

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
I20160617000909 OK Practitioner - Optometry 1254622426 Reassigns benefits to 1 organization
I20160706002382 TX Practitioner - Optometry 1254622426 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1074OKMDAddiction (Substance Use Disorder) Counselor
6680TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Nation CurrentSince Jul 1, 2016 Accepting new patients
Cherokee Nation CurrentSince Jul 1, 2016 Accepting new patients
Cherokee Nation Current Accepting new patients
Northeastern State University College of Optometry Optometrist CurrentSince Jul 1, 2016 Accepting new patients
Cherokee Nation Current Accepting new patients

Locations

859 E Melton Dr
Jay, OK 74346
Phone (918) 253-4271

1001 S 41st St E
#3
Muskogee, OK 74403
Phone (918) 687-0201

1020 Lenape Dr
Nowata, OK 74048
Phone (918) 273-0192

900 N Owen Walters Blvd
Salina, OK 74365
Phone (918) 434-8500

870 E Crafton St
Tahlequah, OK 74464
Phone (918) 444-4000

100 S Bliss Ave
Tahlequah, OK 74464
Phone (918) 458-3100

1001 N Grand Ave
Tahlequah, OK 74464
Phone (918) 456-5511

Dept 2269
Tulsa, OK 74182

27371 S 4410 Rd
Vinita, OK 74301
Phone (918) 256-4800

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239321600000",
    "number": "1093824195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2915 PINE RIDGE RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731206111",
            "telephone_number": "405-752-6515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2915 PINE RIDGE RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731206111",
            "telephone_number": "405-752-6515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "TARA",
        "middle_name": "DAWN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2009-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "1074",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6680T",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.