Vision Source of Hugo, Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2096 Issued in OK

Legal business name

VISION SOURCE OF HUGO, INC.

Practice address

806 E Jackson St
Hugo, OK 74743-4222

Phone

(580) 326-3319

Fax

(580) 326-3310

NPI assigned

Mar 29, 2007

Last updated

Apr 24, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Ginny M Edwards

Title

Office Manager

Phone

(580) 326-3319

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OK2 enrollments

Enrollment records 2

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Jeff S Edwards, O.D.

  • Optometrist
  • Hugo, OK
  • NPI 1114027901

  O20100930062558

  Same enrollment

Tax ID family

Vision Source of Hugo2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Vision Source of Hugo, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Hugo, OK
  • NPI 1922130095
  NPD tax ID

Practitioners 1

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.

• Jeff S Edwards, O.D.

  • Optometrist
  • Hugo, OK
  • NPI 1114027901
  Medicare reassignment NPD

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208995200000",
    "number": "1134249683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 E JACKSON ST",
            "city": "HUGO",
            "state": "OK",
            "postal_code": "747434222",
            "telephone_number": "580-326-3319",
            "fax_number": "580-326-3310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 E JACKSON ST",
            "city": "HUGO",
            "state": "OK",
            "postal_code": "747434222",
            "telephone_number": "580-326-3319",
            "fax_number": "580-326-3310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISION SOURCE OF HUGO, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2008-04-24",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "GINNY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "580-326-3319",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00331640",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100766690A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gweneth Susan Terry-Ball
• The Therapy Tree
• Kashia Nicole Thompson, LMSW
• Joshua Asher Tims, BHRS
• Tricounty Behavioral Health, LLC
• Vision Source of Hugo, Inc.
• Rebecca Ann Wade, COTA
• Victoria Louise Waggoner
• Ruthy M Waight
• Wal-Mart Stores East LP (Walmart Pharmacy 10-0049)

• Optometrist in Hugo, OK
• Providers in Hugo, OK by specialty
• Optometrist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2008; 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.