Anderson Eyecare PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

1069 Issued in OK

Legal business name

ANDERSON EYECARE PC

Practice address

2001 S Elm PL Ste B
Broken Arrow, OK 74012-7025

Phone

(918) 455-4545

Fax

(918) 455-4545

NPI assigned

Aug 7, 2008

Last updated

Mar 3, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Becky F Anderson

Title

Manager

Phone

(918) 455-4545

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Anderson Eyecare PLLC Former legal business name

Locations

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

{
    "created_epoch": "1218067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393804800000",
    "number": "1932355112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 S ELM PL STE B",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740127025",
            "telephone_number": "918-455-4545",
            "fax_number": "918-455-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 S ELM PL STE B",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740127025",
            "telephone_number": "918-455-4545",
            "fax_number": "918-455-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDERSON EYECARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-07",
        "last_updated": "2014-03-03",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "BECKY",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "918-455-4545",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "1069",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VSP",
            "identifier": "9184554545",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "112326",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVESIS",
            "identifier": "63655",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "70357",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anderson Eyecare PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Kirsten Anderson
• Traci Kane Anderson, LCSW

• Optometrist in Broken Arrow, OK
• Providers in Broken Arrow, OK by specialty
• Optometrist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.