Active NPI
Larry Wayne Higgs, O.D.
- Optometrist
- Sapulpa, OK
National Provider Identifier
1366449225
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 0229
- Practice address
- 17 S Oak St
Sapulpa, OK 74066-4312 - Phone
- (918) 224-2610
- Fax
- (918) 224-0613
- NPI assigned
- Jul 6, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 0229 | OK | Primary |
Addresses
Primary practice location
17 S Oak St
Sapulpa, OK 74066-4312
Mailing address
17 S Oak St
Sapulpa, OK 74066-4312
Phone (918) 224-2610
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100763080A | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0229 | OK | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1234396800000",
"number": "1366449225",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 S OAK ST",
"city": "SAPULPA",
"state": "OK",
"postal_code": "740664312",
"telephone_number": "918-224-2610",
"fax_number": "918-224-0613"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17 S OAK ST",
"city": "SAPULPA",
"state": "OK",
"postal_code": "740664312",
"telephone_number": "918-224-2610",
"fax_number": "918-224-0613"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HIGGS",
"first_name": "LARRY",
"middle_name": "WAYNE",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-06",
"last_updated": "2009-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OK",
"license": "0229",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100763080A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sapulpa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.