Active NPI
Charles A Lawrence, M.D.
- Ophthalmology Physician
- Enid, OK
National Provider Identifier
1609874809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 11287
- Practice address
- 615 E Oklahoma Ave
Suite 101
Enid, OK 73701-5951 - Phone
- (580) 233-4711
- Fax
- (580) 234-6686
- NPI assigned
- Jul 12, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 11287 | OK | Primary |
Addresses
Primary practice location
615 E Oklahoma Ave
Suite 101
Enid, OK 73701-5951
Mailing address
615 E Oklahoma Ave
Suite 101
Enid, OK 73701-5951
Phone (580) 233-4711
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100729900A | Medicaid | OK | |
| 862183393 | Other | OK | RAILROAD MEDICARE |
| 0748750001 | Other | OK | CIGNA DMERC |
| 730794467001 | Other | OK | BLUE CROSS BLUE SHIELD |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11287 | OK | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1299628800000",
"number": "1609874809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "615 E OKLAHOMA AVE",
"address_2": "SUITE 101",
"city": "ENID",
"state": "OK",
"postal_code": "737015951",
"telephone_number": "580-233-4711",
"fax_number": "580-234-6686"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615 E OKLAHOMA AVE",
"address_2": "SUITE 101",
"city": "ENID",
"state": "OK",
"postal_code": "737015951",
"telephone_number": "580-233-4711",
"fax_number": "580-234-6686"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAWRENCE",
"first_name": "CHARLES",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-12",
"last_updated": "2011-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "OK",
"license": "11287",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100729900A",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "862183393",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA DMERC",
"identifier": "0748750001",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "730794467001",
"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 Mar 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.