Individual provider Active NPI

Patrina Sattiewhite Walter, OD

  • Optometrist
  • Oklahoma City, OK
National Provider Identifier
1457489437
Registry record updated Jun 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2228 Issued in OK
Practice address
13509 N Meridian Ave Ste 3
Oklahoma City, OK 73120-8396
Phone
(405) 751-0075
Fax
(405) 767-0907
NPI assigned
Mar 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2228 OK Primary

Addresses

Primary practice location

13509 N Meridian Ave Ste 3
Oklahoma City, OK 73120-8396

Mailing address

13509 N Meridian Ave Ste 3
Oklahoma City, OK 73120-8396
Phone (405) 751-0075

Other practice location 1

1726B NE 23rd St
Oklahoma City, OK 73111-3339
Phone (405) 225-1357

Other practice location 2

1726B NE 23rd St
Oklahoma City, OK 73111-3339
Phone (405) 225-1357

Other identifiers 1

IdentifierTypeStateIssuer
100765090AMedicaidOK

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

Interoperability endpoints

  • Direct secure messaging: patrina.sattiewhitewalter@uprisedirect.com

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622764800000",
    "number": "1457489437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13509 N MERIDIAN AVE STE 3",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731208396",
            "telephone_number": "405-751-0075",
            "fax_number": "405-767-0907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13509 N MERIDIAN AVE STE 3",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731208396",
            "telephone_number": "405-751-0075",
            "fax_number": "405-767-0907"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1726B NE 23rd St",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731113339",
            "country_code": "US",
            "telephone_number": "405-225-1357",
            "fax_number": "405-767-0907",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1726B NE 23rd St",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731113339",
            "country_code": "US",
            "telephone_number": "405-225-1357",
            "fax_number": "405-767-0907",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALTER",
        "first_name": "PATRINA",
        "middle_name": "SATTIEWHITE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2021-06-04",
        "certification_date": "2021-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2228",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100765090A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2021; 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.