Family Vision Care of Ponca City

Primary specialty

OptometristTaxonomy code 152W00000X

License

OK2144 Issued in OK

Legal business name

FAMILY VISION CARE OF PONCA CITY

Practice address

1619 N 5TH St
Ponca City, OK 74601-2703

Phone

(580) 762-5700

Fax

(580) 765-3022

NPI assigned

Jun 13, 2007

Last updated

Dec 30, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kelly C Campbell, O.D.NPI 1477867919

Title

Optometrist Owner

Phone

(580) 762-5700

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kelly Christine Campbell, O.D.

  • Optometrist
  • Ponca City, OK
  • NPI 1477867919
  Medicare reassignment Care Compare group Authorized official
• William A Stuever, O.D.

  • Optometrist
  • Ponca City, OK
  • NPI 1659376853
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483056000000",
    "number": "1902000904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1619 N 5TH ST",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746012703",
            "telephone_number": "580-762-5700",
            "fax_number": "580-765-3022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1619 N 5TH ST",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746012703",
            "telephone_number": "580-762-5700",
            "fax_number": "580-765-3022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY VISION CARE OF PONCA CITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-13",
        "last_updated": "2016-12-30",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OPTOMETRIST OWNER",
        "authorized_official_telephone_number": "580-762-5700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "OK",
            "license": "OK2144",
            "primary": false
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "OK",
            "license": "OK2144",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "OK2144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100634170B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bobby Ray Evans
• Chantelle Elizabeth Evans, LPN
• Judith Davina Evans, PHARM.D.
• Fairfax Medical Facilities, Inc. (Ponca City Family Health Center)
• Family Dentistry
• Marty Vaughn Farquharson, CHIROPRACTIC PHYSICI
• Diana Sue Feathers, RN
• Julie Ann Feathers
• Zachary Feightner, DPH.
• Becky Anne Ferguson

• Optometrist in Ponca City, OK
• Providers in Ponca City, OK by specialty
• Optometrist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.