Blake Robert Bush, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2550 Issued in OK

Practice address

908 N Rockford Rd
Suite E
Ardmore, OK 73401-2540

Phone

(580) 223-7333

Fax

(580) 319-4411

NPI assigned

Aug 6, 2008

Last updated

May 12, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 7

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK, TN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Optometry

Education

Other, 2026

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Blake Bush Family Eyecare Inc.Group PAC ID 4486810652, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Blake Bush Family Eyecare Inc.

  • Optometrist
  • Ardmore, OK
  • NPI 1043573470
  Medicare reassignment Care Compare group NPD Authorized official
• J D Hudkins O D Inc

  • Optometrist
  • Broken Arrow, OK
  • NPI 1669509683
  Medicare reassignment NPD
• Tennessee Orthopaedic Alliance PA

  • Orthopaedic Surgery Physician
  • Nashville, TN
  • NPI 1538153937
  Medicare reassignment

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

{
    "created_epoch": "1217980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431388800000",
    "number": "1235395542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 N ROCKFORD RD",
            "address_2": "SUITE E",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734012540",
            "telephone_number": "580-223-7333",
            "fax_number": "580-319-4411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "908 N ROCKFORD RD",
            "address_2": "SUITE E",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734012540",
            "telephone_number": "580-223-7333",
            "fax_number": "580-319-4411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSH",
        "first_name": "BLAKE",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-06",
        "last_updated": "2015-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2550",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "OK",
            "license": "2550",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "OK",
            "license": "2550",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "OK",
            "license": "2550",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "OK",
            "license": "2550",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "OK",
            "license": "2550",
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "OK",
            "license": "2550",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200205700A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimbra Buntin
• Kisha Burkhalter
• Lillie Burkhart
• Lauren Burks
• Lisa Burton
• Debrah Denise Butler, BHRS
• Rebecca Rae Butler, RN MS ARNP
• Rhea Michelle Buycks, PA-C
• Jacqulyn Brooke Byers, MS LPC
• Andres Rodrigo Caero Romero, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.