Organization Active NPI

Tonya Ward Jackson OD PC

  • Optometrist
  • Tulsa, OK
National Provider Identifier
1205017779
Registry record updated Apr 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1196 Issued in OK
Legal business name
TONYA WARD JACKSON OD PC
Practice address
8010 S 101St East Ave
Suite 100
Tulsa, OK 74133-4562
Phone
(918) 252-7432
Fax
(918) 250-9003
NPI assigned
Nov 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2009

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

Authorized official

Name
Dr. Tonya W Jackson, OD
Title
Optometrist
Phone
(918) 252-7432

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1196 OK Primary

Addresses

Primary practice location

8010 S 101St East Ave
Suite 100
Tulsa, OK 74133-4562

Mailing address

8010 S 101St East Ave
Suite 100
Tulsa, OK 74133-4562
Phone (918) 252-7432

Other identifiers 1

IdentifierTypeStateIssuer
100760900BMedicaidOK

Other names 1

  • NEW VISION EYE AND LASER CENTER Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1196035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239840000000",
    "number": "1205017779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8010 S 101ST EAST AVE",
            "address_2": "SUITE 100",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741334562",
            "telephone_number": "918-252-7432",
            "fax_number": "918-250-9003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8010 S 101ST EAST AVE",
            "address_2": "SUITE 100",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741334562",
            "telephone_number": "918-252-7432",
            "fax_number": "918-250-9003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TONYA WARD JACKSON OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-26",
        "last_updated": "2009-04-16",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "TONYA",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "918-252-7432",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OK",
            "license": "1196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100760900B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NEW VISION EYE AND LASER CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.