Individual provider Active NPI

Elizabeth M. Hart-Carlock, O.D.

  • Optometrist
  • Oklahoma City, OK
National Provider Identifier
1376761627
Registry record updated Sep 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3130 Issued in OK
Practice address
2000 W Memorial Rd
Oklahoma City, OK 73134-6506
Phone
(405) 876-6393
NPI assigned
Apr 23, 2007
Last updated
Sep 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT003209 GA
Optometrist 152W00000X 3130 OK Primary

Addresses

Primary practice location

2000 W Memorial Rd
Oklahoma City, OK 73134-6506

Mailing address

2000 W Memorial Rd
Oklahoma City, OK 73134-6506
Phone (405) 876-6393

Other practice location 1

1569 N Expressway
Griffin, GA 30223-1746
Phone (770) 233-6860

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, OK2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200806001126 GA Practitioner - Optometry 2668377433
I20211028002940 OK Practitioner - Optometry 2668377433 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2000 W Memorial Rd
Oklahoma City, OK 73134-6506
Phone (405) 876-6393

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT003209GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Family Eyecare, LLC CurrentSince Sep 19, 2021 Accepting new patients
Senior Eye Associates SC Optometrist Past Accepting new patients
Stein Optical Inc. Optometrist Past Accepting new patients

Locations

2000 W Memorial Rd
Oklahoma City, OK 73134
Phone (405) 752-2888

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632096000000",
    "number": "1376761627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 W MEMORIAL RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731346506",
            "telephone_number": "405-876-6393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 W MEMORIAL RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731346506",
            "telephone_number": "405-876-6393"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1569 N Expressway",
            "address_purpose": "LOCATION",
            "city": "Griffin",
            "state": "GA",
            "postal_code": "302231746",
            "country_code": "US",
            "telephone_number": "770-233-6860",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HART-CARLOCK",
        "first_name": "ELIZABETH",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003209",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "3130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.