Tulsa Vision Clinic, Inc.

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

2356 Issued in OK

Legal business name

TULSA VISION CLINIC, INC.

Practice address

4433 South Harvard Ave.
Tulsa, OK 74135-2604

Phone

(918) 743-6334

Fax

(918) 743-6369

NPI assigned

Feb 23, 2007

Organization subpart

No

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

Authorized official

Name

Dr. John Brian Cheatham, O.D.NPI 1992809032

Title

Optometrist

Phone

(918) 743-6334

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John Brian Cheatham, OD

  • Optometrist
  • Tulsa, OK
  • NPI 1992809032

  OK

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219881600000",
    "number": "1164557625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4433 SOUTH HARVARD AVE.",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352604",
            "telephone_number": "918-743-6334",
            "fax_number": "918-743-6369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4433 SOUTH HARVARD AVE.",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352604",
            "telephone_number": "918-743-6334",
            "fax_number": "918-743-6369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TULSA VISION CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2008-08-28",
        "status": "A",
        "authorized_official_last_name": "CHEATHAM",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "BRIAN",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "918-743-6334",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "OK",
            "license": "2356",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200109710A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tulsa Spine & Specialty Hospital Pharmacy
• Tulsa Therapy Solutions
• Tulsa Time Dental Design
• Tulsa Varicose Vein Center LLC
• Tulsa Vein Institute PLLC
• Tulsa Wellness Management, LLC
• Tulsa Women'S Healthcare, PLLC.
• Tulsa X-Ray Laboratory PLLC
• Tulsa-Amg Specialty Hospital, LLC
• Tulsa'S Affordable Home Care L.L.C

• All providers in Tulsa, OK
• Eyewear Supplier in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.