Individual provider Active NPI

Walter Clay McLaughlin, OD

  • Optometrist
  • Shawnee, OK
National Provider Identifier
1730126905
Registry record updated Nov 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1032 Issued in OK
Practice address
3315 Kethley Rd
Shawnee, OK 74804-9638
Phone
(405) 273-5801
Fax
(405) 878-3814
NPI assigned
May 31, 2006
Last updated
Nov 11, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1032 OK Primary

Addresses

Primary practice location

3315 Kethley Rd
Shawnee, OK 74804-9638

Mailing address

PO Box 849
Shawnee, OK 74802-0849
Phone (405) 273-5801

Other identifiers 1

IdentifierTypeStateIssuer
100765600AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20091231000420 OK Practitioner - Optometry 0648311324 Reassigns benefits to 1 organization
I20170228001758 TX Practitioner - Optometry 0648311324 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Robinson Eye Institute PLLCGroup PAC ID 4082701768, 3 clinicians
Citizen Potawatomi NationGroup PAC ID 3375511488, 35 clinicians

Practice addresses (Care Compare)

501 E Macarthur St
Shawnee, OK 74804-2201
Phone (405) 760-6500

781 Grand Casino Blvd
Shawnee, OK 74804-1005
Phone (405) 964-4025

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Citizen Potawatomi Nation Current Accepting new patients
Robinson Eye Institute PLLC CurrentSince Dec 1, 2021 Accepting new patients
Citizen Potawatomi Nation CurrentSince Feb 6, 2017 Accepting new patients
Robinson Eye Institute PLLC CurrentSince Dec 1, 2021 Accepting new patients
Citizen Potawatomi Nation Current Accepting new patients

Locations

2307 Gordon Cooper Dr
Shawnee, OK 74801
Phone (405) 273-5236

501 E MacArthur St
Shawnee, OK 74804
Phone (405) 275-7400

781 Grand Casino Blvd
Shawnee, OK 74804
Phone (405) 964-4025

Interoperability endpoints

  • FHIR API: https://epicproxy.et1447.epichosted.com/APIProxyPRD/api/FHIR/R4

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478822400000",
    "number": "1730126905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 849",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748020849",
            "telephone_number": "405-273-5801",
            "fax_number": "405-878-3814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3315 KETHLEY RD",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748049638",
            "telephone_number": "405-273-5801",
            "fax_number": "405-878-3814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLAUGHLIN",
        "first_name": "WALTER",
        "middle_name": "CLAY",
        "name_prefix": "Mr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2016-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "1032",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100765600A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee, OK

Sources for this page

Verify at the official NPI Registry.