Michael Watters Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

2408 Issued in OK

Legal business name

MICHAEL WATTERS INC

Practice address

2020 N Harrison
Shawnee, OK 74804

Phone

(405) 273-7075

Fax

(405) 273-7405

NPI assigned

Jun 14, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Lindsey Helen Young

Title

Billing Clerk

Phone

(405) 273-7075

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OK2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 1

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

• Michael Brian Watters, OD

  • Optometrist
  • Shawnee, OK
  • NPI 1164586699
  Medicare reassignment NPD

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214438400000",
    "number": "1265636922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 N HARRISON",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "74804",
            "telephone_number": "405-273-7075",
            "fax_number": "405-273-7405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 N HARRISON",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "74804",
            "telephone_number": "405-273-7075",
            "fax_number": "405-273-7405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL WATTERS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-14",
        "last_updated": "2008-06-26",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "LINDSEY",
        "authorized_official_middle_name": "HELEN",
        "authorized_official_title_or_position": "BILLING CLERK",
        "authorized_official_telephone_number": "405-273-7075",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2408",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "900522241",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200046010A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deidra Rachelle Meredith
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• Deanne Meshew
• Eric Messick
• Mickey Sehorn D.D.S., P.C.
• Midwest City Hma Physician Management LLC
• Midwest City Hma Physician Management, LLC
• Midwest City Hma Physician Management, LLC
• Midwest Rockets HH, LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.