Nathaniel D Edwards OD PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

2845 Issued in OK

Legal business name

NATHANIEL D EDWARDS OD PLLC

Doing business as

Edwards Family Vision

Practice address

1619 W Elk Ave
Duncan, OK 73533-1725

Phone

(580) 255-1172

Fax

(580) 255-1234

NPI assigned

Aug 10, 2015

Last updated

Aug 31, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Nathaniel D Edwards, ODNPI 1366827644

Title

Manager

Phone

(580) 255-1172

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Edwards Family Vision Doing business as

Medicare fee-for-service enrollment

Enrolled in OK2 enrollments

Enrollment records 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nathaniel David Edwards, OD

  • Optometrist
  • Duncan, OK
  • NPI 1366827644
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1439164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440979200000",
    "number": "1518343763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1619 W ELK AVE",
            "city": "DUNCAN",
            "state": "OK",
            "postal_code": "735331725",
            "telephone_number": "580-255-1172",
            "fax_number": "580-255-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1619 W ELK AVE",
            "city": "DUNCAN",
            "state": "OK",
            "postal_code": "735331725",
            "telephone_number": "580-255-1172",
            "fax_number": "580-255-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATHANIEL D EDWARDS OD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-10",
        "last_updated": "2015-08-31",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "NATHANIEL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "580-255-1172",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2845",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200600380A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edwards Family Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Aftan Rachelle Morris-Gay, APRN
• Jordan Murakami, DPT
• Daniel Murillo
• Chantelle Nicole Muse
• Randall Shane Myers
• Karina Lizeth Neff, MS SLP
• Garrett Landon Nelson, DDS
• Michael Earl Nelson, D.D.S.
• Rodney Nelson, DDS
• New Life Counseling Center (New Life Counseling)

• Optometrist in Duncan, OK
• Providers in Duncan, OK by specialty
• Optometrist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.