Organization Active NPI

Affordable Price Vision Ctr Inc

  • Optometrist
  • Oklahoma City, OK
National Provider Identifier
1356348783
Registry record updated Oct 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
809 Issued in OK
Legal business name
AFFORDABLE PRICE VISION CTR INC
Practice address
2700 SW 29TH St
Oklahoma City, OK 73119-1806
Phone
(405) 632-9749
Fax
(405) 632-6331
NPI assigned
Jun 30, 2005
Reactivated
Feb 22, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Dr. Chris J Fry, ODNPI 1295711836
Title
Optometrist Co Owner
Phone
(405) 632-9749

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Practitioners 5

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

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20050124000626 OK Part B Supplier - Clinic/Group Practice 5193775674 Receives reassigned benefits from 2 practitioners
Practice locations: Oklahoma City, OK

National Provider Directory

National Provider Directory

Locations

2700 SW 29th St
Oklahoma City, OK 73119
Phone (405) 632-9749

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 809 OK Primary
Eyewear Supplier 332H00000X 809 OK

Addresses

NPPES NPI Registry

Primary practice location

2700 SW 29TH St
Oklahoma City, OK 73119-1806

Mailing address

2700 SW 29TH St
Oklahoma City, OK 73119-1806
Phone (405) 632-9749

Other identifiers 4

NPPES NPI Registry
IdentifierTypeStateIssuer
100762240BMedicaidOK
200007160AMedicaidOK
100805490CMedicaidOK
200106360AMedicaidOK

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 1, 2008.

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222819200000",
    "number": "1356348783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 SW 29TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731191806",
            "telephone_number": "405-632-9749",
            "fax_number": "405-632-6331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 SW 29TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731191806",
            "telephone_number": "405-632-9749",
            "fax_number": "405-632-6331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFORDABLE PRICE VISION CTR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-30",
        "last_updated": "2008-10-01",
        "deactivation_date": "2006-02-13",
        "reactivation_date": "2006-02-22",
        "status": "A",
        "authorized_official_last_name": "FRY",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OPTOMETRIST CO OWNER",
        "authorized_official_telephone_number": "405-632-9749",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OK",
            "license": "809",
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "OK",
            "license": "809",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100762240B",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200007160A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100805490C",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200106360A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.