Specialty Facial Prosthetics LLC

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

SPECIALTY FACIAL PROSTHETICS LLC

Practice address

229 NW 9TH St Ste 107
Oklahoma City, OK 73102-2619

Phone

(405) 620-0880

NPI assigned

Aug 23, 2018

Last updated

May 3, 2019By 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

Charlesetta M ThompsonNPI 1174186191

Title

Technician

Phone

(405) 595-3226

Specialties & licenses 1

Addresses

Practitioners 3

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.

• Charlesetta Maria Thompson

  • Ocularist
  • Oklahoma City, OK
  • NPI 1174186191
  NPD (past) Authorized official
• Monique La Fuente, OCULARIST

  • Ocularist
  • Oklahoma City, OK
  • NPI 1144759515
  NPD (past)
• Tim Thatcher

  • Ocularist
  • Oklahoma City, OK
  • NPI 1730742057
  NPD (past)

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

{
    "created_epoch": "1534982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556841600000",
    "number": "1760963276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 NW 9TH ST STE 107",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731022619",
            "telephone_number": "405-595-3226",
            "fax_number": "405-600-6296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 NW 9TH ST STE 107",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731022619",
            "telephone_number": "405-620-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALTY FACIAL PROSTHETICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-23",
        "last_updated": "2019-05-03",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "CHARLESETTA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "TECHNICIAN",
        "authorized_official_telephone_number": "405-595-3226"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Customized Equipment (DME) in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Customized Equipment (DME) in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2019; 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.