Organization Active NPI

Claremore Pryor Eye Clinic P a

  • Ophthalmology Physician
  • Claremore, OK
National Provider Identifier
1124076823
Registry record updated Nov 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
CLAREMORE PRYOR EYE CLINIC P A
Practice address
1715 N Lynn Riggs Blvd
Claremore, OK 74017-3056
Phone
(918) 342-4222
NPI assigned
May 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2014

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

Authorized official

Name
David Reinecke, M.D.
Title
Owner
Phone
(918) 342-4222

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

1715 N Lynn Riggs Blvd
Claremore, OK 74017-3056

Mailing address

1715 N Lynn Riggs Blvd
Claremore, OK 74017-3056
Phone (918) 342-4222

Other identifiers 1

IdentifierTypeStateIssuer
100745370AMedicaidOK

National Provider Directory

National Provider Directory

Locations

1715 N Lynn Riggs Blvd
#1
Claremore, OK 74017
Phone (918) 342-4222

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415059200000",
    "number": "1124076823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1715 N LYNN RIGGS BLVD",
            "city": "CLAREMORE",
            "state": "OK",
            "postal_code": "740173056",
            "telephone_number": "918-342-4222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 N LYNN RIGGS BLVD",
            "city": "CLAREMORE",
            "state": "OK",
            "postal_code": "740173056",
            "telephone_number": "918-342-4222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAREMORE PRYOR EYE CLINIC P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-04",
        "last_updated": "2014-11-04",
        "status": "A",
        "authorized_official_last_name": "REINECKE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-342-4222",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100745370A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Claremore, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.