Active NPI
Phillip A Walker, O.D.
- Optometrist
- Edmond, OK
National Provider Identifier
1982757829
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OK0852
- Practice address
- 16135 North May Ave
Suite a
Edmond, OK 73013-0000 - Phone
- (405) 751-5638
- Fax
- (405) 752-1692
- NPI assigned
- Jan 22, 2007
- Last updated
- Mar 17, 2014
- 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 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OK0852 | OK | Primary |
| Corneal and Contact Management Optometrist | 152WC0802X | 852 | OK | |
| Sports Vision Optometrist | 152WS0006X | 852 | OK | |
| Occupational Vision Optometrist | 152WX0102X | 852 | OK | |
| Orthoptist | 156FX1900X | 852 | OK |
Addresses
Primary practice location
16135 North May Ave
Suite a
Edmond, OK 73013-0000
Mailing address
16135 North May Ave
Suite a
Edmond, OK 73013-0000
Phone (405) 751-5638
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OKAAA3556 | Other | OK | PTAN |
| 730983594001 | Other | OK | BLUE CROSS BLUE SHIELD |
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 |
|---|---|---|---|
| 852 | OK | MD | Marriage & Family Therapist |
| OK0852 | OK | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Phillip a. Walker O.D. Inc. | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395014400000",
"number": "1982757829",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16135 NORTH MAY AVE",
"address_2": "SUITE A",
"city": "EDMOND",
"state": "OK",
"postal_code": "730130000",
"telephone_number": "405-751-5638",
"fax_number": "405-752-1692"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16135 NORTH MAY AVE",
"address_2": "SUITE A",
"city": "EDMOND",
"state": "OK",
"postal_code": "730130000",
"telephone_number": "405-751-5638",
"fax_number": "405-752-1692"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "PHILLIP",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-22",
"last_updated": "2014-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OK",
"license": "OK0852",
"primary": true
},
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "OK",
"license": "852",
"primary": false
},
{
"code": "152WS0006X",
"taxonomy_group": "",
"desc": "Optometrist, Sports Vision",
"state": "OK",
"license": "852",
"primary": false
},
{
"code": "152WX0102X",
"taxonomy_group": "",
"desc": "Optometrist, Occupational Vision",
"state": "OK",
"license": "852",
"primary": false
},
{
"code": "156FX1900X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Orthoptist",
"state": "OK",
"license": "852",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTAN",
"identifier": "OKAAA3556",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "730983594001",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Edmond, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.