NPIMap

Organization Active NPI

Michael L Peck

  • Optometrist
  • Enid, OK
National Provider Identifier
1306034830
Registry record updated Aug 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1058 Issued in OK
Legal business name
MICHAEL L PECK
Practice address
517 W Maine Ave
Enid, OK 73701-5542
Phone
(580) 242-2300
Fax
(580) 233-7370
NPI assigned
Oct 10, 2007
Last updated
Aug 26, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2008

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

Authorized official

Name
Dr. Michael L Peck, O.D.NPI 1023026176
Title
Optometrist
Phone
(580) 242-2300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1058 OK Primary
Eyewear Supplier 332H00000X 1058 OK

Addresses

Primary practice location

517 W Maine Ave
Enid, OK 73701-5542

Mailing address

517 W Maine Ave
Enid, OK 73701-5542
Phone (580) 242-2300

National Provider Directory

National Provider Directory

Locations

517 W Maine Ave
Enid, OK 73701
Phone (580) 242-2300

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1191974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219708800000",
    "number": "1306034830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 W MAINE AVE",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737015542",
            "telephone_number": "580-242-2300",
            "fax_number": "580-233-7370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 W MAINE AVE",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737015542",
            "telephone_number": "580-242-2300",
            "fax_number": "580-233-7370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL L PECK",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-10",
        "last_updated": "2008-08-26",
        "status": "A",
        "authorized_official_last_name": "PECK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "580-242-2300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OK",
            "license": "1058",
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "OK",
            "license": "1058",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enid, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.