Active NPI
John D Hudkins, O.D.
- Optometrist
- Broken Arrow, OK
National Provider Identifier
1457447062
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 909
- Practice address
- 4008 S Elm PL
Suite a
Broken Arrow, OK 74011-2021 - Phone
- (918) 455-2020
- Fax
- (918) 455-4030
- NPI assigned
- Oct 4, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 909 | OK | Primary |
| Corneal and Contact Management Optometrist | 152WC0802X | 909 | OK | |
| Low Vision Rehabilitation Optometrist | 152WL0500X | 909 | OK | |
| Pediatric Optometrist | 152WP0200X | 909 | OK | |
| Sports Vision Optometrist | 152WS0006X | 909 | OK | |
| Occupational Vision Optometrist | 152WX0102X | 909 | OK |
Addresses
Primary practice location
4008 S Elm PL
Suite a
Broken Arrow, OK 74011-2021
Mailing address
4008 S Elm PL
Suite a
Broken Arrow, OK 74011-2021
Phone (918) 455-2020
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100766680A | Medicaid | OK | |
| E066 | Other | OK | BLUELINCS |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350345600000",
"number": "1457447062",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4008 S ELM PL",
"address_2": "SUITE A",
"city": "BROKEN ARROW",
"state": "OK",
"postal_code": "740112021",
"telephone_number": "918-455-2020",
"fax_number": "918-455-4030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4008 S ELM PL",
"address_2": "SUITE A",
"city": "BROKEN ARROW",
"state": "OK",
"postal_code": "740112021",
"telephone_number": "918-455-2020",
"fax_number": "918-455-4030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUDKINS",
"first_name": "JOHN",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-04",
"last_updated": "2012-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OK",
"license": "909",
"primary": true
},
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "OK",
"license": "909",
"primary": false
},
{
"code": "152WL0500X",
"taxonomy_group": "",
"desc": "Optometrist, Low Vision Rehabilitation",
"state": "OK",
"license": "909",
"primary": false
},
{
"code": "152WP0200X",
"taxonomy_group": "",
"desc": "Optometrist, Pediatrics",
"state": "OK",
"license": "909",
"primary": false
},
{
"code": "152WS0006X",
"taxonomy_group": "",
"desc": "Optometrist, Sports Vision",
"state": "OK",
"license": "909",
"primary": false
},
{
"code": "152WX0102X",
"taxonomy_group": "",
"desc": "Optometrist, Occupational Vision",
"state": "OK",
"license": "909",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100766680A",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUELINCS",
"identifier": "E066",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Broken Arrow, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.