Andrea B Dudley OD, Inc PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

2215 Issued in OK

Legal business name

ANDREA B DUDLEY OD, INC PC

Practice address

5910 S Lewis Ave
Tulsa, OK 74105-7112

Phone

(918) 745-9700

Fax

(918) 743-8102

NPI assigned

Mar 1, 2007

Last updated

Jul 8, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Andrea Bertalotto Dudley, ODNPI 1568544773

Title

President

Phone

(918) 745-9700

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Practitioners 3

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.

• Andrea Bertalotto Dudley, OD

  • Optometrist
  • Tulsa, OK
  • NPI 1568544773
  Medicare reassignment NPD Authorized official
• Kaylee Bobbitt

  • Optometrist
  • Tulsa, OK
  • NPI 1972295400
  Medicare reassignment NPD (past)
• David Robert Kolker, O.D.

  • Optometrist
  • Tulsa, OK
  • NPI 1073618211
  NPD (past)

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310083200000",
    "number": "1235267394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5910 S LEWIS AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741057112",
            "telephone_number": "918-745-9700",
            "fax_number": "918-743-8102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5910 S LEWIS AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741057112",
            "telephone_number": "918-745-9700",
            "fax_number": "918-743-8102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDREA B DUDLEY OD, INC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2011-07-08",
        "status": "A",
        "authorized_official_last_name": "DUDLEY",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "BERTALOTTO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "918-745-9700",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Anderson, M.S.ED
• Travis Leon Anderson
• Trevor Clayton Anderson, M.D.
• Tristan Daniel Anderson, LPC
• Denise Lizbeth Andino
• Mark Alan Andregg, DDS
• Andrew R Briggeman, DO, LLC
• Karol A. Andrew, P.T.
• Abigail Andrews
• Arin Allen Andrews

• Optometrist in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Optometrist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2011; 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.