NPIMap

Organization Active NPI

Advantage Eyecare, P.C.

  • Optometrist
  • Skiatook, OK
National Provider Identifier
1720116932
Registry record updated Sep 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2211 Issued in OK
Legal business name
ADVANTAGE EYECARE, P.C.
Practice address
5335 W Rogers Blvd
Ste B
Skiatook, OK 74070-5284
Phone
(918) 396-4440
Fax
(918) 396-4449
NPI assigned
Mar 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2009

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

Authorized official

Name
Dr. Scott Michael Carlson, O.D.
Title
President
Phone
(918) 396-4440

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 2211 OK Primary
Corneal and Contact Management OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152WC0802X 2211 OK
Pediatric OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152WP0200X 2211 OK
Sports Vision OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152WS0006X 2211 OK
Optometric Assistant TechnicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 156FX1201X 2211 OK
OpticianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 156FX1800X 2211 OK

Addresses

Primary practice location

5335 W Rogers Blvd
Ste B
Skiatook, OK 74070-5284

Mailing address

5335 W Rogers Blvd
Ste B
Skiatook, OK 74070-5284
Phone (918) 396-4440

Other identifiers 1

IdentifierTypeStateIssuer
100747330AMedicaidOK

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253059200000",
    "number": "1720116932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5335 W ROGERS BLVD",
            "address_2": "STE B",
            "city": "SKIATOOK",
            "state": "OK",
            "postal_code": "740705284",
            "telephone_number": "918-396-4440",
            "fax_number": "918-396-4449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5335 W ROGERS BLVD",
            "address_2": "STE B",
            "city": "SKIATOOK",
            "state": "OK",
            "postal_code": "740705284",
            "telephone_number": "918-396-4440",
            "fax_number": "918-396-4449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANTAGE EYECARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2009-09-16",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "918-396-4440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2211",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "OK",
            "license": "2211",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Pediatrics",
            "state": "OK",
            "license": "2211",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Sports Vision",
            "state": "OK",
            "license": "2211",
            "primary": false
        },
        {
            "code": "156FX1201X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optometric Assistant",
            "state": "OK",
            "license": "2211",
            "primary": false
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "OK",
            "license": "2211",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100747330A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Skiatook, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.