Heritage Park Eye Care Center

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

2413 Issued in OK

Legal business name

HERITAGE PARK EYE CARE CENTER

Doing business as

Vision Source Midwest City

Practice address

2008 S. Post Road
Midwest City, OK 73130

Phone

(405) 732-2277

Fax

(405) 737-4776

NPI assigned

Mar 21, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Corey Christensen, O.D.

Title

Optometrist

Phone

(405) 732-2277

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Vision Source Midwest City Doing business as

Practitioners 1

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

• Russell Laverty, O.D.

  • Optometrist
  • Midwest City, OK
  • NPI 1285798835
  NPD (past)

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210809600000",
    "number": "1730204165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2008 S. POST ROAD",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "73130",
            "telephone_number": "405-732-2277",
            "fax_number": "405-737-4776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2008 S. POST ROAD",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "73130",
            "telephone_number": "405-732-2277",
            "fax_number": "405-737-4776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE PARK EYE CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2008-05-15",
        "status": "A",
        "authorized_official_last_name": "CHRISTENSEN",
        "authorized_official_first_name": "COREY",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "405-732-2277",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "OK",
            "license": "2413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP #",
            "identifier": "CS4518",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vision Source Midwest City",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Wallisa Henderson
• Kelsey Nicole Henson, BS
• Tiffany Shawn Herbert, D. C.
• Heritage Park Eye Care Center
• Heritage Park Eye Care Center
• Heritage Park Eye Care Center
• Heritage Park Medical Center Inc
• Heritage Park Pharmacy, LLC
• Heritage Park Vision Source
• Faith Hernandez

• Eyewear Supplier in Midwest City, OK
• Providers in Midwest City, OK by specialty
• Eyewear Supplier in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; 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.