Active NPI
Thomas Michael Nicholas, OD
- Optometrist
- Enid, OK
National Provider Identifier
1467540674
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 848
- Practice address
- 1204 W Willow Rd
Suite a
Enid, OK 73703-2531 - Phone
- (580) 234-2333
- Fax
- (580) 234-0820
- NPI assigned
- Oct 11, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 848 | OK | Primary |
Addresses
Primary practice location
1204 W Willow Rd
Suite a
Enid, OK 73703-2531
Mailing address
1204 W Willow Rd
Suite a
Enid, OK 73703-2531
Phone (580) 234-2333
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 848 | Other | OK | STATE LICENSE NUMER |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 848 | OK | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1419811200000",
"number": "1467540674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1204 W WILLOW RD",
"address_2": "SUITE A",
"city": "ENID",
"state": "OK",
"postal_code": "737032531",
"telephone_number": "580-234-2333",
"fax_number": "580-234-0820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1204 W WILLOW RD",
"address_2": "SUITE A",
"city": "ENID",
"state": "OK",
"postal_code": "737032531",
"telephone_number": "580-234-2333",
"fax_number": "580-234-0820"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLAS",
"first_name": "THOMAS",
"middle_name": "MICHAEL",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-11",
"last_updated": "2014-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OK",
"license": "848",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE NUMER",
"identifier": "848",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Enid, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.