Organization Active NPI

Ba Vision

  • Optometrist
  • Broken Arrow, OK
National Provider Identifier
1194979765
Registry record updated Apr 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
BA VISION
Practice address
521 S Aspen Ave
Broken Arrow, OK 74012-2296
Phone
(918) 258-9999
Fax
(918) 258-2850
NPI assigned
Nov 10, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2009

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

Authorized official

Name
Stacey D Murrell, ODNPI 1619984481
Title
Gen PTR
Phone
(918) 258-9999

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

521 S Aspen Ave
Broken Arrow, OK 74012-2296

Mailing address

521 S Aspen Ave
Broken Arrow, OK 74012-2296
Phone (918) 258-9999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090312000107 OK Part B Supplier - Clinic/Group Practice 2860558152 Receives reassigned benefits from 2 practitioners
Practice locations: Broken Arrow, OK
O20100930079525 OK DME Supplier - Physician - Optometrist 2860558152 Practice locations: Broken Arrow, OK

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Broken Arrow Vision Clinic521 S Aspen Ave, Broken Arrow, OK 74012-2296(918) 258-9999 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Nov 1, 2008

National Provider Directory

National Provider Directory

Locations

521 S Aspen Ave
Broken Arrow, OK 74012
Phone (918) 258-9999

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1226275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240617600000",
    "number": "1194979765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 S ASPEN AVE",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740122296",
            "telephone_number": "918-258-9999",
            "fax_number": "918-258-2850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 S ASPEN AVE",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740122296",
            "telephone_number": "918-258-9999",
            "fax_number": "918-258-2850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BA VISION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-10",
        "last_updated": "2009-04-25",
        "status": "A",
        "authorized_official_last_name": "MURRELL",
        "authorized_official_first_name": "STACEY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "GEN PTR",
        "authorized_official_telephone_number": "918-258-9999",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broken Arrow, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.