Active NPI
John D Edwards, O.D.
- Optometrist
- Elk City, OK
National Provider Identifier
1821059940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 958
- Practice address
- 101 N Randall Ave
Elk City, OK 73644-5231 - Phone
- (580) 225-1980
- Fax
- (580) 225-8648
- NPI assigned
- Mar 29, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 958 | OK | Primary |
Addresses
Primary practice location
101 N Randall Ave
Elk City, OK 73644-5231
Mailing address
PO Box 624
Elk City, OK 73648-0624
Phone (580) 225-1980
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 731122948002 | Other | OK | DEPT OF REHABILITATIVE SE |
| 410027999 | Other | OK | RAILROAD PROVIDER # |
| 100759880B | Medicaid | OK | |
| 731122948002 | Other | OK | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DRS. Ford and Edwards, PLLC | Optometrist | Past | Accepting new patients |
| Eyecare of Western Oklahoma PC | Optometrist | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Optometrist
- Elk City, OK
- NPI 1225369267
-
- Optometrist
- Elk City, OK
- NPI 1265780761
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143590400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311638400000",
"number": "1821059940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 624",
"city": "ELK CITY",
"state": "OK",
"postal_code": "736480624",
"telephone_number": "580-225-1980",
"fax_number": "580-225-8648"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 N RANDALL AVE",
"city": "ELK CITY",
"state": "OK",
"postal_code": "736445231",
"telephone_number": "580-225-1980",
"fax_number": "580-225-8648"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "JOHN",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-29",
"last_updated": "2011-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OK",
"license": "958",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT OF REHABILITATIVE SE",
"identifier": "731122948002",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD PROVIDER #",
"identifier": "410027999",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100759880B",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "731122948002",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elk City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.