The Eye Site, PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

2861 Issued in OK

Legal business name

THE EYE SITE, PLLC

Practice address

921 Oklahoma Blvd Ste a
Alva, OK 73717-2631

Phone

(580) 732-2393

NPI assigned

Feb 21, 2018

Last updated

Feb 21, 2018By 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. Callie Mosburg, ODNPI 1912382441

Title

Owner

Phone

(580) 732-2393

Specialties & licenses 2

Addresses

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.

• Callie Mosburg, O.D.

  • Optometrist
  • Alva, OK
  • NPI 1912382441
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1519171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519171200000",
    "number": "1710488275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 MYERS DR",
            "city": "ALVA",
            "state": "OK",
            "postal_code": "737173504",
            "telephone_number": "580-732-2393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 OKLAHOMA BLVD STE A",
            "city": "ALVA",
            "state": "OK",
            "postal_code": "737172631",
            "telephone_number": "580-732-2393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE EYE SITE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-21",
        "last_updated": "2018-02-21",
        "status": "A",
        "authorized_official_last_name": "MOSBURG",
        "authorized_official_first_name": "CALLIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "580-732-2393",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2861",
            "primary": true
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist, Vision Therapy",
            "state": "OK",
            "license": "2861",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reva D Spencer
• State of Oklahoma
• Darbi Lyn Sterling Hinde, PT
• Kasey L Swayden, PA-C
• Tabitha Talley
• Molly Mae Thompson, B.S., CMII, BHRS
• Thunder Canyon Counseling Center, Inc.
• Marisa Ashlee Tolson, PHARMD
• Alissa Ryan Trekell
• Trina Piper-Hughbanks O D Inc

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2018; 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.