Organization Active NPI

Tami R Ross, PC

Doing business as Leadership Square EyeCare

  • Optometrist
  • Oklahoma City, OK
National Provider Identifier
1114139680
Registry record updated Mar 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2025 Issued in OK
Legal business name
TAMI R ROSS, PC
Doing business as
Leadership Square EyeCare
Practice address
211 N Robinson Ave
Ste 130
Oklahoma City, OK 73102-7109
Phone
(405) 232-0877
Fax
(405) 232-5956
NPI assigned
May 4, 2007
Last updated
Mar 12, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2010

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

Authorized official

Name
Dr. Tami Ra Ross, O.D.NPI 1285638627
Title
President
Phone
(405) 232-0877

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 2025 OK Primary

Addresses

Primary practice location

211 N Robinson Ave
Ste 130
Oklahoma City, OK 73102-7109

Mailing address

211 N Robinson Ave
Ste 130
Oklahoma City, OK 73102-7109
Phone (405) 232-0877

Other identifiers 1

IdentifierTypeStateIssuer
1285638627OtherOKIND. NPI

Other names 1

  • Leadership Square EyeCare Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060103000185 OK Part B Supplier - Clinic/Group Practice 5799707980 Receives reassigned benefits from 2 practitioners
Practice locations: Oklahoma City, OK

National Provider Directory

National Provider Directory

Locations

211 N Robinson Ave
Ste N130
Oklahoma City, OK 73102
Phone (405) 232-0877

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268352000000",
    "number": "1114139680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 N ROBINSON AVE",
            "address_2": "STE 130",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731027109",
            "telephone_number": "405-232-0877",
            "fax_number": "405-232-5956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 N ROBINSON AVE",
            "address_2": "STE 130",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731027109",
            "telephone_number": "405-232-0877",
            "fax_number": "405-232-5956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAMI R ROSS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2010-03-12",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "TAMI",
        "authorized_official_middle_name": "RA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "405-232-0877",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IND. NPI",
            "identifier": "1285638627",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Leadership Square EyeCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2010; 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.

Verify at the official NPI Registry.