NPIMap

Organization Active NPI

Success Vision Express of Tulsa, LLC

  • Optometrist
  • Tulsa, OK
National Provider Identifier
1922280965
Registry record updated Sep 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2049 Issued in OK
Legal business name
SUCCESS VISION EXPRESS OF TULSA, LLC
Practice address
7472 E Admiral PL
Tulsa, OK 74115-7913
Phone
(918) 834-2929
Fax
(918) 834-4005
NPI assigned
Dec 1, 2007
Last updated
Sep 7, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
SUCCESS VISION EXPRESSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 7, 2021

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

Authorized official

Name
Rose Davydova
Title
Authorized Official
Phone
(918) 800-2020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2049 OK Primary

Addresses

Primary practice location

7472 E Admiral PL
Tulsa, OK 74115-7913

Mailing address

7472 E Admiral PL
Tulsa, OK 74115-7913
Phone (918) 794-9029

Other names 1

  • Dr. Presley and Associates Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090528000650 OK Part B Supplier - Clinic/Group Practice 4587713235 Receives reassigned benefits from 13 practitioners
Practice locations: Tulsa, OK

National Provider Directory

National Provider Directory
Part of
Success Vision Services LLC

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1196467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630972800000",
    "number": "1922280965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7472 E ADMIRAL PL",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741157913",
            "telephone_number": "918-794-9029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7472 E ADMIRAL PL",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741157913",
            "telephone_number": "918-834-2929",
            "fax_number": "918-834-4005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUCCESS VISION EXPRESS OF TULSA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUCCESS VISION EXPRESS",
        "enumeration_date": "2007-12-01",
        "last_updated": "2021-09-07",
        "certification_date": "2021-09-07",
        "status": "A",
        "authorized_official_last_name": "DAVYDOVA",
        "authorized_official_first_name": "ROSE",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "918-800-2020"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Presley and Associates",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Dr. Presley and Associates",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2021; 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.