Individual provider Active NPI

Cody Greenhaw, OD

  • Optometrist
  • Oklahoma City, OK
National Provider Identifier
1487845954
Registry record updated Aug 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2526 Issued in OK
Practice address
2501 W Memorial Rd Ste 259a
Oklahoma City, OK 73134-8039
Phone
(405) 749-0220
Fax
(405) 749-0279
NPI assigned
Aug 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2526 OK Primary

Addresses

Primary practice location

2501 W Memorial Rd Ste 259a
Oklahoma City, OK 73134-8039

Mailing address

2501 W Memorial Rd Ste 259a
Oklahoma City, OK 73134-8039
Phone (405) 749-0220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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 1

Enrollment IDStateProvider typePAC IDDetails
I20080728000390 OK Practitioner - Optometry 9830263623 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midtown Optical PLLCGroup PAC ID 4789865395, 2 clinicians

Practice addresses (Care Compare)

1106 Classen Dr
Oklahoma City, OK 73103-2608
Phone (405) 604-0987

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2526OKMDPhysical Therapy Assistant

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186531200000",
    "number": "1487845954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 W MEMORIAL RD STE 259A",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731348039",
            "telephone_number": "405-749-0220",
            "fax_number": "405-749-0279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 W MEMORIAL RD STE 259A",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731348039",
            "telephone_number": "405-749-0220",
            "fax_number": "405-749-0279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENHAW",
        "first_name": "CODY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-08",
        "last_updated": "2007-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.