Individual provider Active NPI

Debbie S Coy, OD

  • Optometrist
  • Fort Gibson, OK
National Provider Identifier
1407874993
Registry record updated Jan 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2297 Issued in OK
Practice address
330 E Highway 62
Fort Gibson, OK 74434-8446
Phone
(918) 478-8888
Fax
(918) 478-3465
NPI assigned
Jul 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2297 OK Primary

Addresses

Primary practice location

330 E Highway 62
Fort Gibson, OK 74434-8446

Mailing address

330 E Highway 62
Fort Gibson, OK 74434-8446
Phone (918) 478-8888

Other identifiers 1

IdentifierTypeStateIssuer
100679010BMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in 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
I20100830000604 OK Practitioner - Optometry 0345364246
O20100930053612 OK DME Supplier - Physician - Optometrist 7113026956 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fort Gibson, OK

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2297OKMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326326400000",
    "number": "1407874993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 E HIGHWAY 62",
            "city": "FORT GIBSON",
            "state": "OK",
            "postal_code": "744348446",
            "telephone_number": "918-478-8888",
            "fax_number": "918-478-3465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 E HIGHWAY 62",
            "city": "FORT GIBSON",
            "state": "OK",
            "postal_code": "744348446",
            "telephone_number": "918-478-8888",
            "fax_number": "918-478-3465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COY",
        "first_name": "DEBBIE",
        "middle_name": "S",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2012-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2297",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100679010B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Gibson, OK

Sources for this page

Verify at the official NPI Registry.