Chickasaw Nation Division of Health

Primary specialty

OpticianTaxonomy code 156FX1800X

Legal business name

CHICKASAW NATION DIVISION OF HEALTH

Doing business as

Oklahoma Optical

Practice address

1005 N Country Club Rd
Ada, OK 74820-2847

Phone

(580) 332-2796

Fax

(580) 421-4523

NPI assigned

Aug 29, 2006

Last updated

Dec 4, 2015By 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

Mr. Richard Shane Boatright

Title

Oklahoma Optical Manager

Phone

(580) 332-2796

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Oklahoma Optical Doing business as

Locations

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449187200000",
    "number": "1376652180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 N COUNTRY CLUB RD",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748202847",
            "telephone_number": "580-332-2796",
            "fax_number": "580-332-3360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 N COUNTRY CLUB RD",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748202847",
            "telephone_number": "580-332-2796",
            "fax_number": "580-421-4523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICKASAW NATION DIVISION OF HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2015-12-04",
        "status": "A",
        "authorized_official_last_name": "BOATRIGHT",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "SHANE",
        "authorized_official_title_or_position": "OKLAHOMA OPTICAL MANAGER",
        "authorized_official_telephone_number": "580-332-2796",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100768150A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oklahoma Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Chickasaw Nation
• Chickasaw Nation - Family Services
• Chickasaw Nation Division of Commerce (Oklahoma Optical)
• Chickasaw Nation Division of Health (Chickasaw Nation Medical Center)
• Chickasaw Nation Division of Health (Chickasaw Nation Medical Center)
• Chickasaw Nation Division of Health (Chickasaw Nation Medical Center)
• Chickasaw Nation Division of Health (Chickasaw Nation Medical Center)
• Chickasaw Nation Division of Health (Chickasaw Nation Refill Center)
• Chickasaw Nation Division of Health
• Chickasaw Nation Division of Health (Chickasaw Nation Medical Center Outpatient Pharmacy)

• Optician in Ada, OK
• Providers in Ada, OK by specialty
• Optician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2015; 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.