Active NPI
Crossroads Vision Center, PC
- Optometrist
- Oklahoma City, OK
National Provider Identifier
1124380399
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 923
- Legal business name
- CROSSROADS VISION CENTER, PC
- Practice address
- 3200 SW 89TH St
Oklahoma City, OK 73159-7902 - Phone
- (405) 692-2526
- Fax
- (405) 692-2187
- NPI assigned
- Jun 13, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Randel Sterling Hicks, O.D.
- Title
- Owner
- Phone
- (405) 692-2526
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 923 | OK | Primary |
Addresses
Primary practice location
3200 SW 89TH St
Oklahoma City, OK 73159-7902
Mailing address
3200 SW 89TH St
Oklahoma City, OK 73159-7902
Phone (405) 692-2526
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100761420B | Medicaid | OK |
National Provider Directory
National Provider DirectoryLocations
3200 SW 89th St
Oklahoma City, OK 73159
Phone (405) 692-2526
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Optometrist
- Oklahoma City, OK
- NPI 1164531109
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339545600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1339545600000",
"number": "1124380399",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3200 SW 89TH ST",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731597902",
"telephone_number": "405-692-2526",
"fax_number": "405-692-2187"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3200 SW 89TH ST",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731597902",
"telephone_number": "405-692-2526",
"fax_number": "405-692-2187"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CROSSROADS VISION CENTER, PC",
"organizational_subpart": "NO",
"enumeration_date": "2012-06-13",
"last_updated": "2012-06-13",
"status": "A",
"authorized_official_last_name": "HICKS",
"authorized_official_first_name": "RANDEL",
"authorized_official_middle_name": "STERLING",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "405-692-2526",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "O.D."
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": "OK",
"license": "923",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100761420B",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Oklahoma City, OK
- Terah Crosson, APRN
- Crosspoint Medical Inc
- Crossroads Family Dentistry
- Crossroads Hospice of Oklahoma City, LLC
- Crossroads Hospice of Oklahoma City, LLC
- Crossroads Vision Center, PC
- Crossway Medical Clinic W Memorial PLLC
- Crossway Now, LLC
- Christin Ann Crosswhite, RT, BSRT (R)
- Dallas Leigh Crotty, OTR/L
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.