Individual provider Active NPI

James Doyle Coffey, O.D.

  • Optometrist
  • Clinton, OK
National Provider Identifier
1902020050
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2061 Issued in OK
Practice address
817 Avant Ave
Suite 2
Clinton, OK 73601-3957
Phone
(580) 323-1515
Fax
(580) 323-2521
NPI assigned
Apr 12, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2061 OK Primary

Addresses

Primary practice location

817 Avant Ave
Suite 2
Clinton, OK 73601-3957

Mailing address

817 Avant Ave
Suite 2
Clinton, OK 73601-3957
Phone (580) 323-1515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20090427000235 TX Practitioner - Optometry 8527168673 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wewoka Indian HealthGroup PAC ID 7517911415, 43 clinicians

Practice addresses (Care Compare)

36640 Hwy 270
Wewoka, OK 74884

36640 Hwy 270
Wewoka, OK 74884-4021
Phone (405) 257-6282

PO Box
Suite 1475
Wewoka, OK 74884

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wewoka Indian Health CurrentSince Jul 17, 2013 Accepting new patients

Locations

36640 Highway 270
#C
Wewoka, OK 74884
Phone (405) 257-6282

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902020050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 AVANT AVE",
            "address_2": "SUITE 2",
            "city": "CLINTON",
            "state": "OK",
            "postal_code": "736013957",
            "telephone_number": "580-323-1515",
            "fax_number": "580-323-2521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 AVANT AVE",
            "address_2": "SUITE 2",
            "city": "CLINTON",
            "state": "OK",
            "postal_code": "736013957",
            "telephone_number": "580-323-1515",
            "fax_number": "580-323-2521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COFFEY",
        "first_name": "JAMES",
        "middle_name": "DOYLE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, OK

Sources for this page

Verify at the official NPI Registry.