Individual provider Active NPI

Ryanne Elizabeth Elmer Brown, O.D.

  • Optometrist
  • Oklahoma City, OK
National Provider Identifier
1588049456
Registry record updated Jun 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2838 Issued in OK
Practice address
3011 NW 63Rd St
Oklahoma City, OK 73116
Phone
(405) 840-2800
Fax
(405) 840-8242
NPI assigned
Jul 21, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2838 OK Primary

Addresses

Primary practice location

3011 NW 63Rd St
Oklahoma City, OK 73116

Mailing address

11013 Hefner Pointe Dr
Oklahoma City, OK 73120-5035
Phone (405) 751-2020

Other practice location 1

3011 NW 63rd St
Oklahoma City, OK 73116-3629
Phone (405) 840-2800

Other identifiers 1

IdentifierTypeStateIssuer
200606180AMedicaidOK

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
I20151012002078 OK Practitioner - Optometry 2466761507 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Childrens Eye Care P L L CGroup PAC ID 7214104728, 6 clinicians

Practice addresses (Care Compare)

11013 Hefner Pointe Dr
Oklahoma City, OK 73120-5035
Phone (405) 751-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Eye Care P L L C CurrentSince Jan 1, 2018 Accepting new patients
Oklahoma City Vision Source Optometrist CurrentSince Oct 1, 2015 Accepting new patients
Hefner Pointe Youth Optical Past Accepting new patients

Locations

615 E Oklahoma Ave
Enid, OK 73701
Phone (405) 751-2020

11013 Hefner Pointe Dr
Oklahoma City, OK 73120
Phone (405) 751-2020

3011 NW 63rd St
Oklahoma City, OK 73116
Phone (405) 840-2800

Organizations & group practices 3

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": "1437436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530230400000",
    "number": "1588049456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11013 HEFNER POINTE DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731205035",
            "telephone_number": "405-751-2020",
            "fax_number": "405-751-3838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3011 NW 63RD ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73116",
            "telephone_number": "405-840-2800",
            "fax_number": "405-840-8242"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3011 NW 63rd St",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731163629",
            "country_code": "US",
            "telephone_number": "405-840-2800",
            "fax_number": "405-840-8242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "RYANNE",
        "middle_name": "ELIZABETH ELMER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-21",
        "last_updated": "2018-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2838",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200606180A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.