Family Eye Care of Shawnee PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

FAMILY EYE CARE OF SHAWNEE PLLC

Practice address

2109 N Kickapoo Ave
Shawnee, OK 74804-2732

Phone

(405) 275-2020

Fax

(405) 275-4129

NPI assigned

Jan 8, 2015

Last updated

Nov 11, 2016By 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

Kirk F Hoster, ODNPI 1649373689

Title

Partner

Phone

(405) 275-2020

Specialties & licenses 1

Addresses

Other identifiers 4

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 2

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.

• Jordan Scott Ewert, O.D.

  • Optometrist
  • Shawnee, OK
  • NPI 1124374426
  Medicare reassignment
• Kirk F Hoster, OD

  • Optometrist
  • Shawnee, OK
  • NPI 1649373689
  Authorized official Same address or phone

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

{
    "created_epoch": "1420675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478822400000",
    "number": "1316335615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2109 N KICKAPOO AVE",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748042732",
            "telephone_number": "405-275-2020",
            "fax_number": "405-275-4129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2109 N KICKAPOO AVE",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748042732",
            "telephone_number": "405-275-2020",
            "fax_number": "405-275-4129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY EYE CARE OF SHAWNEE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-08",
        "last_updated": "2016-11-11",
        "status": "A",
        "authorized_official_last_name": "HOSTER",
        "authorized_official_first_name": "KIRK",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "405-275-2020",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO",
            "identifier": "0577720001",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100764300A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "731350800001",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200463520A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eternal Kingdom Enterprises Inc. (Bolling's Handyman Services)
• Eternal Kingdom Enterprises, Inc. (Bolling's Handyman Service)
• Rylee Evans, SLP
• Jordan Scott Ewert, O.D.
• Faith 7 Activity Center
• Family Healthcare Associates PLLC
• Family Medicine Specialists, P.C.
• Dana Darlene Farriell, MASTERS COUNSELING
• Cierra Farris
• Fastcare Medical Clinic of Shawnee

• 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 Nov 11, 2016; 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.