Individual provider Active NPI

Courtney Simon

  • Optometrist
  • Stilwell, OK
National Provider Identifier
1114663085
Registry record updated Feb 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3197 Issued in OK
Practice address
471688 Ok-51
Stilwell, OK 74960
Phone
(918) 696-8800
NPI assigned
May 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3197 OK Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

471688 Ok-51
Stilwell, OK 74960

Mailing address

117 S Blackstone
Vian, OK 74962-1437
Phone (918) 931-9506

Other practice location 1

117 S Blackstone
Vian, OK 74962-1437
Phone (918) 773-5045

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
I20220811000254 OK Practitioner - Optometry 5193108975 Reassigns benefits to 2 organizations
I20221013002248 TX Practitioner - Optometry 5193108975 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cherokee NationGroup PAC ID 5799698742, 446 clinicians

Practice addresses (Care Compare)

117 S Blackstone
Vian, OK 74962-1437
Phone (918) 773-5045

PO Box
Suite 849
Vian, OK 74962-0849

RR 5 Box
Suite 840
Stilwell, OK 74960-9222
Phone (918) 696-8800

Hospital & facility affiliations

  • Cherokee Nation W W Hastings Indian Hospital Hospital, Tahlequah, OK, CCN 370171

Merit-based Incentive Payment System (MIPS)

Final score
85.4 of 100Reported as group
Quality
72.78
Promoting interoperability
98
Improvement activities
40
Cost
76.77

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery24

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Nation CurrentSince Jul 26, 2022 Accepting new patients
Vian Eye Clinic PLLC Optometrist CurrentSince Jul 29, 2025 Accepting new patients
Cherokee Nation CurrentSince Jul 26, 2022 Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients
Northeastern State University College of Optometry Optometrist CurrentSince Aug 1, 2022 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

471688 Highway 51
Stilwell, OK 74960

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

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

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

19600 E Ross St
Tahlequah, OK 74464
Phone (539) 234-1000

Dept 2269
Tulsa, OK 74182

117 S Blackstone
Vian, OK 74962
Phone (918) 773-5045

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

Organizations & group practices 7

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 2

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": "1652313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770336000000",
    "number": "1114663085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 S BLACKSTONE",
            "city": "VIAN",
            "state": "OK",
            "postal_code": "749621437",
            "telephone_number": "918-931-9506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "471688 OK-51",
            "city": "STILWELL",
            "state": "OK",
            "postal_code": "74960",
            "telephone_number": "918-696-8800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "117 S Blackstone",
            "address_purpose": "LOCATION",
            "city": "Vian",
            "state": "OK",
            "postal_code": "749621437",
            "country_code": "US",
            "telephone_number": "918-773-5045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMON",
        "first_name": "COURTNEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-12",
        "last_updated": "2026-02-06",
        "certification_date": "2026-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "3197",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stilwell, OK

Sources for this page

Verify at the official NPI Registry.