Organization Active NPI

Visionary Realm Optometry PLLC

  • Optometrist
  • Midwest City, OK
National Provider Identifier
1205633633
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
VISIONARY REALM OPTOMETRY PLLC
Practice address
1620 Midtown PL
Midwest City, OK 73130-6347
Phone
(405) 458-9393
Fax
(405) 610-0321
NPI assigned
Feb 25, 2025
Last updated
Jul 2, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

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

Authorized official

Name
Dr. Alichia Cox, ODNPI 1174976591
Title
Optometrist
Phone
(405) 458-9393

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X Primary
Corneal and Contact Management Optometrist 152WC0802X
Pediatric Optometrist 152WP0200X
Sports Vision Optometrist 152WS0006X
Vision Therapy Optometrist 152WV0400X

Addresses

Primary practice location

1620 Midtown PL
Midwest City, OK 73130-6347

Mailing address

1620 Midtown PL
Midwest City, OK 73130-6347
Phone (405) 458-9393

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250626003718 OK Part B Supplier - Clinic/Group Practice 2961915681 Receives reassigned benefits from 1 practitioner
Practice locations: Midwest City, OK

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1740441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751414400000",
    "number": "1205633633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 MIDTOWN PL",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731306347",
            "telephone_number": "405-458-9393",
            "fax_number": "405-610-0321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 MIDTOWN PL",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731306347",
            "telephone_number": "405-458-9393",
            "fax_number": "405-610-0321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISIONARY REALM OPTOMETRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-25",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A",
        "authorized_official_last_name": "COX",
        "authorized_official_first_name": "ALICHIA",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "405-458-9393",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midwest City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2025; 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.