Individual provider Active NPI

Cody Scott Ward

  • Optometrist
  • Tulsa, OK
National Provider Identifier
1184364093
Registry record updated Sep 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3207 Issued in OK
Practice address
10010 E 81St St Ste 100
Tulsa, OK 74133-4558
Phone
(918) 444-4000
NPI assigned
Mar 30, 2022
Last updated
Sep 25, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3207 OK Primary

Addresses

Primary practice location

10010 E 81St St Ste 100
Tulsa, OK 74133-4558

Mailing address

23522 230TH St.
Fergus Falls, MN 56537
Phone (218) 205-7875

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, ND2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240306000468 MN Practitioner - Optometry 6305282914 Reassigns benefits to 1 organization
I20240416002398 ND Practitioner - Optometry 6305282914 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fergus Falls Vision Care PAGroup PAC ID 1456263706, 5 clinicians

Practice addresses (Care Compare)

810 N Baird Ave
Fergus Falls, MN 56537-1617
Phone (218) 736-5609

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3207OKMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Fergus Falls Vision Care PA Optometrist CurrentSince Apr 1, 2024 Accepting new patients
Lance K Bergstrom MD, PC Optometrist CurrentSince Apr 1, 2024 Accepting new patients
Steven B Thom, MD PC PastSince Apr 1, 2024 Accepting new patients

Locations

810 N Baird Ave
Fergus Falls, MN 56537
Phone (218) 736-5609

2601 University Dr S
Fargo, ND 58103
Phone (701) 235-5200

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1648598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664064000000",
    "number": "1184364093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23522 230TH ST.",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "56537",
            "telephone_number": "218-205-7875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10010 E 81ST ST STE 100",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741334558",
            "telephone_number": "918-444-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARD",
        "first_name": "CODY",
        "middle_name": "SCOTT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-30",
        "last_updated": "2022-09-25",
        "certification_date": "2022-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "3207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.