Organization Active NPI

Omni Eye Center Edmond Inc.

  • Optometrist
  • Edmond, OK
National Provider Identifier
1902936347
Registry record updated Jul 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2311 Issued in OK
Legal business name
OMNI EYE CENTER EDMOND INC.
Practice address
1333 West 33Rd Street
Edmond, OK 73013-6306
Phone
(405) 478-4444
Fax
(405) 478-4497
NPI assigned
Mar 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2009

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

Authorized official

Name
Dr. Ryan Jeffrey Melton, O.D.NPI 1881738029
Title
President
Phone
(405) 478-4444

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X 2311 OK Primary

Addresses

Primary practice location

1333 West 33Rd Street
Edmond, OK 73013-6306

Mailing address

1333 West 33Rd Street
Edmond, OK 73013-6306
Phone (405) 478-4444

Other identifiers 2

IdentifierTypeStateIssuer
731396793001OtherOKBLUE CROSS BLUE SHIELD
0968340001OtherOKCIGNA GOVERNMENT SERVICES DMERC

Other names 1

  • Omni Eye Center - Laser Vision Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080905000251 OK Part B Supplier - Clinic/Group Practice 3072689686 Receives reassigned benefits from 3 practitioners
Practice locations: Edmond, OK

National Provider Directory

National Provider Directory

Locations

1333 W 33rd St
Edmond, OK 73013
Phone (405) 317-8678

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247011200000",
    "number": "1902936347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 WEST 33RD STREET",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730136306",
            "telephone_number": "405-478-4444",
            "fax_number": "405-478-4497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 WEST 33RD STREET",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730136306",
            "telephone_number": "405-478-4444",
            "fax_number": "405-478-4497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMNI EYE CENTER EDMOND INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2009-07-08",
        "status": "A",
        "authorized_official_last_name": "MELTON",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "JEFFREY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "405-478-4444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "731396793001",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA GOVERNMENT SERVICES DMERC",
            "identifier": "0968340001",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Omni Eye Center - Laser Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Edmond, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.