Organization Active NPI

Norman Vision Clinic PLLC

  • Optometrist
  • Norman, OK
National Provider Identifier
1376659417
Registry record updated Jun 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
NORMAN VISION CLINIC PLLC
Practice address
2501 Boardwalk
Norman, OK 73069-6372
Phone
(405) 321-2155
Fax
(405) 321-1170
NPI assigned
Aug 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2021

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

Authorized official

Name
Mr. Troy Allen Flax, ODNPI 1902912041
Title
Owner Partner
Phone
(405) 321-2155

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

2501 Boardwalk
Norman, OK 73069-6372

Mailing address

2501 Boardwalk
Norman, OK 73069-6372
Phone (405) 321-2155

Other identifiers 1

IdentifierTypeStateIssuer
1007646450AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060110000688 OK Part B Supplier - Clinic/Group Practice 4981627593 Receives reassigned benefits from 7 practitioners
1 other NPI on this enrollment
Practice locations: Moore, OK; Norman, OK
O20100930043568 OK DME Supplier - Physician - OptometristDME Supplier - Optician 4981627593 Practice locations: Norman, OK

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

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

SupplierSuppliesMedicare assignment
Norman Vision Clinic PLLC2501 Boardwalk, Norman, OK 73069-6372(405) 321-2155 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Jul 1, 1995

National Provider Directory

National Provider Directory
Tax ID family
Norman Vision Clinic LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

705 City Ave
Moore, OK 73160
Phone (405) 794-7544

3121 S Telephone Rd
Moore, OK 73160
Phone (405) 321-0370

2501 Boardwalk
Norman, OK 73069
Phone (405) 321-2155

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623628800000",
    "number": "1376659417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 BOARDWALK",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730696372",
            "telephone_number": "405-321-2155",
            "fax_number": "405-321-1170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 BOARDWALK",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730696372",
            "telephone_number": "405-321-2155",
            "fax_number": "405-321-1170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORMAN VISION CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-22",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A",
        "authorized_official_last_name": "FLAX",
        "authorized_official_first_name": "TROY",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "OWNER PARTNER",
        "authorized_official_telephone_number": "405-321-2155",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007646450A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norman, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2021; 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.