NPIMap

Organization Active NPI

Mid-del Vision Source, PLLC

  • Eyewear Supplier
  • Midwest City, OK
National Provider Identifier
1982940508
Registry record updated Jan 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
MID-DEL VISION SOURCE, PLLC
Practice address
2008 S Post Rd
Midwest City, OK 73130-6610
Phone
(405) 732-2277
Fax
(405) 737-4776
NPI assigned
Dec 31, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2014

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

Authorized official

Name
Michelle Stricklin
Title
Asst. Director of Operations
Phone
(405) 732-2277

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

2008 S Post Rd
Midwest City, OK 73130-6610

Mailing address

2008 S Post Rd
Midwest City, OK 73130-6610
Phone (405) 732-2277

Other names 1

  • Vision Source Midwest City Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131113001833 OK Part B Supplier - Clinic/Group Practice 3274768239 Receives reassigned benefits from 9 practitioners
1 other NPI on this enrollment
Practice locations: Del City, OK; Midwest City, OK

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

4650 SE 15th St
Del City, OK 73115
Phone (405) 677-8831

Interoperability endpoints

  • Direct secure messaging: slee@middelvisionsource.eyefinity-direct.com
  • Direct secure messaging: mccrackin@middelvisionsource.eyefinity-direct.com
  • Direct secure messaging: jpoe@middelvisionsource.eyefinity-direct.com
  • Direct secure messaging: hunter@middelvisionsource.eyefinity-direct.com
  • Direct secure messaging: bobbyc@middelvisionsource.eyefinity-direct.com
  • Direct secure messaging: jsmay@middelvisionsource.eyefinity-direct.com
  • Direct secure messaging: tblue@middelvisionsource.eyefinity-direct.com
  • Direct secure messaging: coreyc@middelvisionsource.eyefinity-direct.com
  • Direct secure messaging: acox@middelvisionsource.eyefinity-direct.com

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1356912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389312000000",
    "number": "1982940508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2008 S POST RD",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731306610",
            "telephone_number": "405-732-2277",
            "fax_number": "405-737-4776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2008 S POST RD",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731306610",
            "telephone_number": "405-732-2277",
            "fax_number": "405-737-4776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-DEL VISION SOURCE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-31",
        "last_updated": "2014-01-10",
        "status": "A",
        "authorized_official_last_name": "STRICKLIN",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "ASST. DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "405-732-2277"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vision Source Midwest City",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Midwest City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2014; 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.