Edmond Regional Eye Associates Inc

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

EDMOND REGIONAL EYE ASSOCIATES INC

Practice address

920 S Bryant
Ste 100
Edmond, OK 73034

Phone

(405) 341-4238

NPI assigned

Aug 17, 2006

Organization subpart

No

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

Authorized official

Name

Robert D Gourley, MDNPI 1093704793

Title

Owner of Practice

Phone

(405) 341-4238

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

Practitioners 5

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

• Robert D Gourley, MD

  • Ophthalmology Physician
  • Edmond, OK
  • NPI 1093704793
  Medicare reassignment Care Compare group NPD Authorized official
• Bradley Adam Daniel, OD

  • Optometrist
  • Oklahoma City, OK
  • NPI 1689227217
  Medicare reassignment Care Compare group NPD
• Michael Andrew Hogue, MD

  • Ophthalmology Physician
  • Edmond, OK
  • NPI 1902895600
  Medicare reassignment Care Compare group NPD
• Vincent David Venincasa, M.D.

  • Ophthalmology Physician
  • Edmond, OK
  • NPI 1154709970
  Medicare reassignment NPD
• Carl L. Sylvester, MD

  • Ophthalmology Physician
  • Oklahoma City, OK
  • NPI 1831241587
  NPD (past)

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205949609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 S BRYANT",
            "address_2": "STE 100",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "73034",
            "telephone_number": "405-341-4238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 S BRYANT",
            "address_2": "STE 100",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "73034",
            "telephone_number": "405-341-4238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDMOND REGIONAL EYE ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GOURLEY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER OF PRACTICE",
        "authorized_official_telephone_number": "405-341-4238",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CH6423",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edmond Physician Services LLC
• Edmond Podiatry Associates LLC
• Edmond Premier Drug LLC
• Edmond Primary Care LLC
• Edmond Public Schools
• Edmond Speech Therapy LLC
• Edmond Urgent Care Inc.
• Edmond Wheelchair Repair & Supply, LLC
• Edmondson Family Therapy
• Jennifer Erin Edmondson, LPC, LADC, CMIII

• Ophthalmology Physician in Edmond, OK
• Providers in Edmond, OK by specialty
• Ophthalmology Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.