Active NPI
Robert L. Irby Jr., OD
- Optometrist
- Holdenville, OK
National Provider Identifier
1942200969
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 831
- Practice address
- 121 W Main St
Holdenville, OK 74848-3229 - Phone
- (405) 379-3610
- Fax
- (405) 379-2019
- NPI assigned
- Aug 1, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 831 | OK | Primary |
Addresses
Primary practice location
121 W Main St
Holdenville, OK 74848-3229
Mailing address
PO Box 897
Holdenville, OK 74848-0897
Phone (405) 379-3610
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 831 | OK | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Canadian Valley Vision Center, PC | Optometrist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Optometrist
- Holdenville, OK
- NPI 1639329071
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1246233600000",
"number": "1942200969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 897",
"city": "HOLDENVILLE",
"state": "OK",
"postal_code": "748480897",
"telephone_number": "405-379-3610",
"fax_number": "405-379-2019"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "121 W MAIN ST",
"city": "HOLDENVILLE",
"state": "OK",
"postal_code": "748483229",
"telephone_number": "405-379-3610",
"fax_number": "405-379-2019"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IRBY",
"first_name": "ROBERT",
"middle_name": "L.",
"name_suffix": "Jr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-01",
"last_updated": "2009-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OK",
"license": "831",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Holdenville, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.