NPIMap

Individual provider Active NPI

Olin W Fenton, OD

  • Optometrist
  • Talihina, OK
National Provider Identifier
1164416574
Registry record updated Nov 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2417 Issued in OK
Practice address
200 Dallas St
Talihina, OK 74571-2402
Phone
(918) 567-3424
Fax
(918) 567-3420
NPI assigned
Aug 31, 2005
Last updated
Nov 12, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6474TG TX
Optometrist 152W00000X 2417 OK Primary

Addresses

Primary practice location

200 Dallas St
Talihina, OK 74571-2402

Mailing address

200 Dallas St
Talihina, OK 74571-2402
Phone (918) 567-3424

Other identifiers 1

IdentifierTypeStateIssuer
81289QOtherTXTEXAS BCBS PROVIDER NUMBE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, OK2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040209000345 TX Practitioner - Optometry 5395639702 Reassigns benefits to 1 organization
I20110104001156 OK Practitioner - Optometry 5395639702 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Choctaw Nation of OklahomaGroup PAC ID 1759294838, 271 clinicians

Practice addresses (Care Compare)

1 Choctaw Way
Talihina, OK 74571-2022
Phone (539) 316-6391

205 Dallas St
Talihina, OK 74571-2402
Phone (539) 316-6391

415 6TH St
Boswell, OK 74727-2072
Phone (580) 566-2530

One Choctaw Way
Talihina, OK 74571-2022

PO Box
Clayton, OK 74536

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
77.07 of 100Reported as group
Quality
73.06
Improvement activities
40
Cost
69.92

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery17
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6474TGTXMDOptometrist
2417OKMDNeuromusculoskeletal Medicine & OMM Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Choctaw Nation of Oklahoma CurrentSince Mar 19, 2007 Accepting new patients
Choctaw Nation of Oklahoma CurrentSince Mar 19, 2007 Accepting new patients
Choctaw Nation of Oklahoma Current Accepting new patients
Texarkana Eye Associates Optometrist Past Accepting new patients
Choctaw Nation of Oklahoma Past Accepting new patients

Locations

1585 W Liberty Rd
Atoka, OK 74525
Phone (580) 889-1981

1300 E Martin Luther King Dr
Broken Bow, OK 74728
Phone (580) 208-2204

410 N M St
Hugo, OK 74743
Phone (580) 326-7561

902 E Lincoln Rd
Idabel, OK 74745
Phone (580) 286-2600

1127 S George Nigh Expy
McAlester, OK 74501
Phone (800) 349-7026

109 Kerr Blvd
Poteau, OK 74953
Phone (918) 649-1100

2204 E Main St
Stigler, OK 74462
Phone (918) 967-9200

1 Choctaw Way
Talihina, OK 74571
Phone (918) 423-8440

205 Dallas St
Talihina, OK 74571
Phone (918) 567-3636

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GEIDAA/Endpoint/GEIDAA
  • Direct secure messaging: ofenton19358@choctawnation.direct-ci.com
  • Direct secure messaging: olin.fentonod@pfmcok.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762905600000",
    "number": "1164416574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 DALLAS ST",
            "city": "TALIHINA",
            "state": "OK",
            "postal_code": "745712402",
            "telephone_number": "918-567-3424",
            "fax_number": "918-567-3420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 DALLAS ST",
            "city": "TALIHINA",
            "state": "OK",
            "postal_code": "745712402",
            "telephone_number": "918-567-3424",
            "fax_number": "918-567-3420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENTON",
        "first_name": "OLIN",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6474TG",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2417",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS BCBS PROVIDER NUMBE",
            "identifier": "81289Q",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Talihina, OK

Sources for this page

Verify at the official NPI Registry.