Burness R Yandell, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

970 Issued in OK

Practice address

1013 S Main St
Grove, OK 74344-2847

Phone

(918) 786-9777

Fax

(918) 786-3345

NPI assigned

Jun 7, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern College of Optometry, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eyecare of Grand Lake PLLCGroup PAC ID 1557768769, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Eyecare of Grand Lake PLLC

  • Optometrist
  • Grove, OK
  • NPI 1932774189
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249430400000",
    "number": "1962442848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 452529",
            "city": "GROVE",
            "state": "OK",
            "postal_code": "743452529",
            "telephone_number": "918-786-9777",
            "fax_number": "918-786-3345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1013 S MAIN ST",
            "city": "GROVE",
            "state": "OK",
            "postal_code": "743442847",
            "telephone_number": "918-786-9777",
            "fax_number": "918-786-3345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANDELL",
        "first_name": "BURNESS",
        "middle_name": "R",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2009-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANTRA FREEDOM",
            "identifier": "1962442848",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110763110A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "731086218001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Megan Wilmering
• Kelsey R Wisdom, M.S., CCC-SLP
• Jaquelynn Jean Wood
• Kyle C Wooderson, D.O.
• Nichole Marie Wooton
• Yco, Inc
• Brandon Yeager
• Katie Young
• Kevin James Yunt, D.O.
• Cody Zabel

• Optometrist in Grove, OK
• Providers in Grove, OK by specialty
• Optometrist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.