Individual provider Active NPI

Devany Dougherty

  • Optometrist
  • Muskogee, OK
National Provider Identifier
1235616822
Registry record updated Jul 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2978 Issued in OK
Practice address
1011 Honor Heights Dr
Muskogee, OK 74401-1318
Phone
(918) 577-3000
NPI assigned
Jul 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2978 OK Primary

Addresses

Primary practice location

1011 Honor Heights Dr
Muskogee, OK 74401-1318

Mailing address

7541 S Mingo Rd
Tulsa, OK 74133-3227

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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 1

Enrollment IDStateProvider typePAC IDDetails
I20200610000072 OK Practitioner - Optometry 2466873955 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Perini Eyecare PLLCGroup PAC ID 2062796659, 3 clinicians

Practice addresses (Care Compare)

4002 S Yale Ave
Suite B
Tulsa, OK 74135-6070
Phone (918) 663-3937

7104 S Sheridan Rd
Suite 4
Tulsa, OK 74133-2765
Phone (918) 496-2900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Perini Eyecare, PLLC Optometrist CurrentSince Jun 1, 2020 Accepting new patients

Locations

7104 S Sheridan Rd
Ste 4
Tulsa, OK 74133
Phone (918) 496-2900

4002 S Yale Ave
Ste B
Tulsa, OK 74135
Phone (918) 663-3937

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1532563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532563200000",
    "number": "1235616822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7541 S MINGO RD",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741333227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 HONOR HEIGHTS DR",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744011318",
            "telephone_number": "918-577-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "DEVANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-26",
        "last_updated": "2018-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskogee, OK

Sources for this page

Verify at the official NPI Registry.