EDMOND REGIONAL EYE ASSOCIATES INC (NPI# 1205949609) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205949609 |
| Entity Type | Organization |
| Organization Name | EDMOND REGIONAL EYE ASSOCIATES INC |
| Practice Address |
920 S Bryant Ste 100 Edmond OK 73034 |
| Practice Telephone | 4053414238 |
| Mailing Telephone | 4053414238 |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | ROBERT D GOURLEY (OWNER OF PRACTICE) |
| Authorized Official Telephone | 4053414238 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RR MEDICARE | CH6423 | 01 |
| Street Address |
920 S BRYANT STE 100 |
| City | EDMOND |
| State | OK |
| Zip Code | 73034 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306447172 | Saints Medical Group, LLC | Family Medicine | 2749 Progressive Dr, Suite B, Edmond, OK 73034 | 2020-11-06 |
| 1194339861 | Susan Haesook Kim | Pharmacist | 1400 2nd St, Edmod, Edmond, OK 73034 | 2020-09-01 |
| 1821616038 | Aaron Michael Gowens | Specialist/Technologist | 015 Wantland Hall 100 University Dr., Edmond, OK 73034 | 2020-07-14 |
| 1043834849 | Paddington Place Lcc | Intermediate Care Facility, Mental Illness | 3225 French Park Drive, Suite 6, Edmond, OK 73034 | 2020-06-08 |
| 1083254932 | Purpose Healthcare Inc | Psychologist | 301 South Blvd, Suite 117, Edmond, OK 73034 | 2020-01-08 |
| 1740773662 | Healthcare Express, LLP | Family Medicine | 2300 E 2nd St, Edmond, OK 73034 | 2018-06-14 |
| 1427555713 | Sara Nicole Smith | Specialist/Technologist | 100 N University Drive, Attn: Athletic Training Room, Edmond, OK 73034 | 2018-04-12 |
| 1619475084 | Carissa Leigh Brackelsberg | Chiropractor | 3709 E 2nd St, Edmond, OK 73034 | 2018-01-31 |
| 1760996177 | Laurel Michelle Glendening | Physical Therapist | 3531 River Wood Lane, Edmond, OK 73034 | 2017-11-21 |
| 1134643380 | Keith S Quinn | Dentist | 3008 Peaceful Ln, Edmond, OK 73034 | 2017-07-31 |
| Find all providers in zip 73034 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154709970 | Vincent David Venincasa | Ophthalmology | 920 S Bryant Ave Ste 100, Edmond, OK 73034-5803 | 2015-05-13 |
| 1811284946 | Retina Vitreous Center, Pllc | Ophthalmology | 1008 Nw 139th Street Parkway, Edmond, OK 73013-9791 | 2011-07-10 |
| 1730476730 | Jared Jackson | Ophthalmology | 3431 S Boulevard Ste 105, Edmond, OK 73013-5514 | 2011-06-29 |
| 1306904123 | Erin L Holloman | Ophthalmology | 16315 N May Ave, Edmond, OK 73013-8892 | 2006-12-05 |
| 1558435099 | Jeffrey T Shaver PC | Ophthalmology | 3840 S Boulevard, Suite 101, Edmond, OK 73013-5478 | 2006-11-17 |
| 1588671408 | Virgil Jerry Shepherd | Ophthalmology | 3431 S Boulevard, Suite 106, Edmond, OK 73013 | 2006-08-02 |
| 1780634782 | Ryan Ridges | Ophthalmology | 1008 Nw 139th Street Pkwy, Edmond, OK 73013-9791 | 2006-05-11 |
| 1124088067 | Thomas C Wolf | Ophthalmology | 3431 S Boulevard St, Suite 106, Edmond, OK 73013-5475 | 2006-03-24 |
| 1073582409 | Jeffrey T Shaver | Ophthalmology | 3840 South Boulevard, Suite 101, Edmond, OK 73013-5478 | 2006-03-16 |
| 1053388504 | Laura Sarfatis Miles | Ophthalmology | 912 Nw 139th Street Pkwy, Edmond, OK 73013-9525 | 2006-03-03 |
| Find all providers in EDMOND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.