Individual provider Active NPI

Donald Jay Farris, O.D.

  • Optometrist
  • Tulsa, OK
National Provider Identifier
1902872146
Registry record updated Jun 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
935 Issued in OK
Practice address
1501 S Yale Ave
Tulsa, OK 74112-6217
Phone
(918) 744-5700
Fax
(918) 744-0711
NPI assigned
Feb 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 935 OK Primary

Addresses

Primary practice location

1501 S Yale Ave
Tulsa, OK 74112-6217

Mailing address

1501 S Yale Ave
Tulsa, OK 74112-6217
Phone (918) 744-5700

Other identifiers 1

IdentifierTypeStateIssuer
100761980AMedicaidOK

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
I20100921001536 OK Practitioner - Optometry 9830215359 Practice locations: Tulsa, OK

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
935OKMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277424000000",
    "number": "1902872146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 S YALE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741126217",
            "telephone_number": "918-744-5700",
            "fax_number": "918-744-0711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 S YALE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741126217",
            "telephone_number": "918-744-5700",
            "fax_number": "918-744-0711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRIS",
        "first_name": "DONALD",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2010-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100761980A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.