Individual provider Active NPI

Valerie Ridgena Hatley

  • Optometrist
  • Yukon, OK
National Provider Identifier
1326028838
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OK2245 Issued in OK
Practice address
621 W Main St
Yukon, OK 73099-1035
Phone
(405) 354-2788
NPI assigned
Jan 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OK2245 OK Primary

Addresses

Primary practice location

621 W Main St
Yukon, OK 73099-1035

Mailing address

621 W Main St
Yukon, OK 73099-1035
Phone (405) 354-2788

Other names 1

  • Valerie Ridgena Smith Former name

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
I20071203000136 OK Practitioner - Optometry 2264521095 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1998
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

621 W Main St
Yukon, OK 73099-1035
Phone (405) 354-2788

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2245OKMDOccupational Therapy Assistant

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": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1326028838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 W MAIN ST",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730991035",
            "telephone_number": "405-354-2788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 W MAIN ST",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730991035",
            "telephone_number": "405-354-2788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATLEY",
        "first_name": "VALERIE",
        "middle_name": "RIDGENA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-19",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "OK2245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VALERIE",
            "last_name": "SMITH",
            "middle_name": "RIDGENA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Yukon, OK

Sources for this page

Verify at the official NPI Registry.