Poage Eyecare, PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

2430 Issued in OK

Legal business name

POAGE EYECARE, PC

Practice address

1432 N Mustang Rd
Mustang, OK 73064-7214

Phone

(405) 256-0126

Fax

(405) 256-0563

NPI assigned

Dec 21, 2006

Last updated

Jun 13, 2024By 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. Rebecca Lynn Poage, ODNPI 1245210020

Title

Owner

Phone

(405) 256-0126

Specialties & licenses 5

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

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.

• Rebecca Lynn Poage, OD

  • Optometrist
  • Mustang, OK
  • NPI 1245210020
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718236800000",
    "number": "1639233612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1432 N MUSTANG RD",
            "city": "MUSTANG",
            "state": "OK",
            "postal_code": "730647214",
            "telephone_number": "405-256-0126",
            "fax_number": "405-256-0563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1432 N MUSTANG RD",
            "city": "MUSTANG",
            "state": "OK",
            "postal_code": "730647214",
            "telephone_number": "405-256-0126",
            "fax_number": "405-256-0563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POAGE EYECARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A",
        "authorized_official_last_name": "POAGE",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-256-0126",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "OK",
            "license": "2430",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2430",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "OK",
            "license": "2430",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "OK",
            "license": "2430",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "OK",
            "license": "2430",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20006384830A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Phillip D Grimes P C (Phillip D. Grimes, O.D.)
• Serenity Pierce
• Shania Pina
• Peyton Pinkerton
• Yanesha Pleimann
• Rebecca Lynn Poage, OD
• Fallon Rae Potter
• Lacey Potter
• Roger Goel Potts, DDS
• Stefanie Renae Powell, RBT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; 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.