Organization Active NPI

Bright Eyes Family Eyecare, PLLC

  • Optometrist
  • Oklahoma City, OK
National Provider Identifier
1912284167
Registry record updated Aug 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2630 Issued in OK
Legal business name
BRIGHT EYES FAMILY EYECARE, PLLC
Practice address
9424 N May Ave
Oklahoma City, OK 73120-2712
Phone
(405) 751-8851
Fax
(405) 751-5058
NPI assigned
Nov 15, 2011
Last updated
Aug 17, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2020

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

Authorized official

Name
Dr. Bryan L Womack, ODNPI 1376774406
Title
Owner/Optometrist
Phone
(405) 751-8851

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
Optometrist 152W00000X 2630 OK Primary

Addresses

Primary practice location

9424 N May Ave
Oklahoma City, OK 73120-2712

Mailing address

9424 N May Ave
Oklahoma City, OK 73120-2712
Phone (405) 751-8851

Other identifiers 1

IdentifierTypeStateIssuer
1912284167MedicaidOK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120126000154 OK Part B Supplier - Clinic/Group Practice 4789851171 Receives reassigned benefits from 1 practitioner
Practice locations: Oklahoma City, OK

National Provider Directory

National Provider Directory

Locations

9424 N May Ave
Oklahoma City, OK 73120
Phone (405) 751-8851

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1321315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597622400000",
    "number": "1912284167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9424 N MAY AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731202712",
            "telephone_number": "405-751-8851",
            "fax_number": "405-751-5058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9424 N MAY AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731202712",
            "telephone_number": "405-751-8851",
            "fax_number": "405-751-5058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHT EYES FAMILY EYECARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-15",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A",
        "authorized_official_last_name": "WOMACK",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "405-751-8851",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1912284167",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2020; 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.