Individual provider Active NPI

Shelly Deann Rice, O.D.

  • Optometrist
  • Wagoner, OK
National Provider Identifier
1881602407
Registry record updated Apr 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2284 Issued in OK
Practice address
512 E Cherokee St
Wagoner, OK 74467-4710
Phone
(918) 485-4775
Fax
(918) 485-7611
NPI assigned
Aug 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2284 OK Primary

Addresses

Primary practice location

512 E Cherokee St
Wagoner, OK 74467-4710

Mailing address

512 E Cherokee St
Wagoner, OK 74467-4710
Phone (918) 485-4775

Other identifiers 1

IdentifierTypeStateIssuer
100761650BMedicaidOK

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
I20091228000577 OK Practitioner - Optometry 1658411541 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

512 E Cherokee St
Rice Family Eye Care
Wagoner, OK 74467-4710
Phone (918) 485-4775

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery25

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2284OKMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Shelly Rice OD PC Inc Optometrist CurrentSince Sep 1, 2002 Accepting new patients

Locations

512 E Cherokee St
Wagoner, OK 74467
Phone (918) 485-4775

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745971200000",
    "number": "1881602407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 E CHEROKEE ST",
            "city": "WAGONER",
            "state": "OK",
            "postal_code": "744674710",
            "telephone_number": "918-485-4775",
            "fax_number": "918-485-7611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 E CHEROKEE ST",
            "city": "WAGONER",
            "state": "OK",
            "postal_code": "744674710",
            "telephone_number": "918-485-4775",
            "fax_number": "918-485-7611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICE",
        "first_name": "SHELLY",
        "middle_name": "DEANN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100761650B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wagoner, OK

Sources for this page

Verify at the official NPI Registry.