Individual provider Active NPI

Clint McKinley Sproul, O.D.

  • Optometrist
  • Enid, OK
National Provider Identifier
1851672323
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2712 Issued in OK
Practice address
2318 N Oakwood Rd
Enid, OK 73703-1490
Phone
(580) 242-2300
NPI assigned
Aug 29, 2011
Last updated
Dec 9, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2712 OK Primary

Addresses

Primary practice location

2318 N Oakwood Rd
Enid, OK 73703-1490

Mailing address

2318 N Oakwood Rd
Enid, OK 73703-1490
Phone (580) 242-2300

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20120919000593 OK Practitioner - Optometry 7911155759 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Eyecare of Enid PLLCGroup PAC ID 5799000634, 3 clinicians

Practice addresses (Care Compare)

2318 N Oakwood Rd
Enid, OK 73703-1490
Phone (580) 242-2300

Merit-based Incentive Payment System (MIPS)

Final score
50 of 100Reported as group
Quality
0
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2712OKMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Eyecare of Enid PLLC Optometrist CurrentSince Apr 26, 2023 Accepting new patients
Michael L Peck Optometrist Past Accepting new patients

Locations

2318 N Oakwood Rd
Enid, OK 73703
Phone (580) 242-2300

517 W Maine Ave
Enid, OK 73701
Phone (580) 242-2300

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1314576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1851672323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2318 N OAKWOOD RD",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737031490",
            "telephone_number": "580-242-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2318 N OAKWOOD RD",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737031490",
            "telephone_number": "580-242-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPROUL",
        "first_name": "CLINT",
        "middle_name": "MCKINLEY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-29",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enid, OK

Sources for this page

Verify at the official NPI Registry.