Active NPI
James Larry Charles Jr., OD
- Optometrist
- Edmond, OK
National Provider Identifier
1184681306
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OK2094
- Practice address
- 523 S Santa Fe Ave
Ste a
Edmond, OK 73003-6291 - Phone
- (405) 330-1100
- Fax
- (405) 330-1192
- NPI assigned
- May 1, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OK2094 | OK | Primary |
Addresses
Primary practice location
523 S Santa Fe Ave
Ste a
Edmond, OK 73003-6291
Mailing address
523 S Santa Fe Ave
Ste a
Edmond, OK 73003-6291
Phone (405) 330-1100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080516000490 | OK | Practitioner - Optometry | 7315016326 | Practice locations: Edmond, OK |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Other, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
523 S Santa Fe Ave
Suite a
Edmond, OK 73003-6291
Phone (405) 330-1100
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 13 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OK2094 | OK | MD | Optometrist |
| 2094 | OK | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216252800000",
"number": "1184681306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "523 S SANTA FE AVE",
"address_2": "STE A",
"city": "EDMOND",
"state": "OK",
"postal_code": "730036291",
"telephone_number": "405-330-1100",
"fax_number": "405-330-1192"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "523 S SANTA FE AVE",
"address_2": "STE A",
"city": "EDMOND",
"state": "OK",
"postal_code": "730036291",
"telephone_number": "405-330-1100",
"fax_number": "405-330-1192"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHARLES",
"first_name": "JAMES",
"middle_name": "LARRY",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-01",
"last_updated": "2008-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OK",
"license": "OK2094",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edmond, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.