Organization Active NPI

Total Optical LLC

  • Ophthalmology Physician
  • Yukon, OK
National Provider Identifier
1154941078
Registry record updated Jun 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
TOTAL OPTICAL LLC
Practice address
4400 Grant Blvd
Suite 106
Yukon, OK 73099
Phone
(405) 603-4744
NPI assigned
Apr 21, 2020
Last updated
Jun 17, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2020

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

Authorized official

Name
Chadwick Branch, ODNPI 1962810085
Title
Member
Phone
(405) 603-4744

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 2

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

Addresses

Primary practice location

4400 Grant Blvd
Suite 106
Yukon, OK 73099

Mailing address

4400 Grant Blvd
Suite 106
Yukon, OK 73099
Phone (405) 603-4744

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200506000191 OK Part B Supplier - Clinic/Group Practice 2860823911 Receives reassigned benefits from 1 practitioner
Practice locations: Yukon, OK

National Provider Directory

National Provider Directory

Locations

4400 Grant Blvd
Ste 106
Yukon, OK 73099
Phone (405) 603-4744

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1587427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592352000000",
    "number": "1154941078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 GRANT BLVD",
            "address_2": "SUITE 106",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "73099",
            "telephone_number": "405-603-4744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 GRANT BLVD",
            "address_2": "SUITE 106",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "73099",
            "telephone_number": "405-603-4744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL OPTICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-21",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A",
        "authorized_official_last_name": "BRANCH",
        "authorized_official_first_name": "CHADWICK",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "405-603-4744",
        "authorized_official_credential": "OD"
    },
    "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": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yukon, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2020; 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.