Scott M. Carlson OD PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

2211 Issued in OK

Legal business name

SCOTT M. CARLSON OD PC

Practice address

506 S Cleveland St
Enid, OK 73703-5523

Phone

(580) 233-8200

Fax

(580) 233-7510

NPI assigned

Mar 2, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Kristie Carlson

Title

Practice Administrator

Phone

(580) 233-8200

Specialties & licenses 6

Addresses

Other identifiers 3

Other names 1

• Advantage Eyecare Doing business as

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

Practitioners 2

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

• Scott Michael Carlson, O.D.

  • Optometrist
  • Skiatook, OK
  • NPI 1235243544
  Medicare reassignment
• Jimmy D Smart, OD

  • Optometrist
  • Woodward, OK
  • NPI 1114983897
  NPD (past)

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517875200000",
    "number": "1801924519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 S CLEVELAND ST",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737035523",
            "telephone_number": "580-233-8200",
            "fax_number": "580-233-7510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 S CLEVELAND ST",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737035523",
            "telephone_number": "580-233-8200",
            "fax_number": "580-233-7510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT M. CARLSON OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-02",
        "last_updated": "2018-02-06",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "KRISTIE",
        "authorized_official_title_or_position": "PRACTICE  ADMINISTRATOR",
        "authorized_official_telephone_number": "580-233-8200",
        "authorized_official_name_prefix": "Mrs."
    },
    "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": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "5196410001",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100749000A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100767350A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advantage Eyecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marlys Schroeder, P.T.
• Cristopher D Schultz, D.O.
• Holli Denise Schultz, P.T.
• Haylee Schwandt
• Scott K. McEachern, O.D.
• Lindsey Scott-Gormal
• Joy Leigh Scott
• Michael B Scott, DO
• Rhonda Kaylene Scott, LPC
• Roy E Scott, DDS

• Optometrist in Enid, OK
• Providers in Enid, OK by specialty
• Optometrist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.