Cooper Blakeslee Wyrick, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3050 Issued in OK

Practice address

433 Stone Wood Dr
Broken Arrow, OK 74012-1026

Phone

(918) 615-2696

NPI assigned

Jul 23, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

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 1

Specialty

Optometry

Education

University of Houston - College of Optometry, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rose Rock Eyecare PLLCGroup PAC ID 9234500406, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Rose Rock Eyecare PLLC

  • Optometrist
  • Jenks, OK
  • NPI 1962146639
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1563840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1790338259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 E AQUARIUM PL",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740376811",
            "telephone_number": "918-296-4733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 STONE WOOD DR",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740121026",
            "telephone_number": "918-615-2696"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "317 E Aquarium Pl",
            "address_purpose": "LOCATION",
            "city": "Jenks",
            "state": "OK",
            "postal_code": "740376811",
            "country_code": "US",
            "telephone_number": "918-296-4733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYRICK",
        "first_name": "COOPER",
        "middle_name": "BLAKESLEE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-23",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "3050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emma Kate Wright
• Robert Jeffrey Wright, DO
• Wrightsman Healthcare Solutions LLC
• Augusta Elizabeth Arling Wyatt, PHARMD
• Jonathan Hunter Wyatt
• Gold Maomee Xiong, PHARMD
• Marina Xiong
• Pavoua Xiong, RBT
• Mai Yang Yang
• Weslee Yang

• Optometrist in Broken Arrow, OK
• Providers in Broken Arrow, OK by specialty
• Optometrist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.