DR. KYLE HENDERSON (NPI# 1780069609) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780069609 |
| Entity Type | Individual |
| Full Name | DR. KYLE HENDERSON |
| Credential | OD |
| Practice Address |
501 E 15th St Suite 101 Edmond OK 73013-5043 |
| Practice Telephone | 4053412062 |
| Mailing Telephone | 4053412062 |
| Enumeration Date | 2015-07-21 |
| Last Update Date | 2015-07-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 2853 | OK | Eye and Vision Services Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174120695 | Kyle Henderson | Contractor | 2346 S Lynhurst Dr Ste 200, Indianapolis, IN 46241-5135 | 2020-10-07 |
| 1952782690 | Kyle Henderson | Pharmacist | 11990 Business Park Blvd N, Champlin, MN 55316-2005 | 2015-06-17 |
| 1134547599 | Kyle Henderson | Physician Assistant | 200 Porter Dr, Suite 215, San Ramon, CA 94583-1587 | 2014-04-02 |
| 1295776821 | Kyle Henderson | Pediatrics | 1602 Rock Prairie Rd, College Station, TX 77845-8306 | 2006-06-08 |
| Street Address |
501 E 15TH ST SUITE 101 |
| City | EDMOND |
| State | OK |
| Zip Code | 73013-5043 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114924628 | Andrea Michelle Blank | Social Worker | 501 E 15th St, Suite 500a, Edmond, OK 73013-5043 | 2005-06-30 |
| 1376097618 | Michelle Blank, Lcsw, Pllc | Social Worker | 501 E 15th St, 500a, Edmond, OK 73013-5043 | 2016-08-03 |
| 1932558533 | Emily Stubblefield Lpc LLC | Counselor | 501 E 15th St, Suite 500a, Edmond, OK 73013-5043 | 2016-06-06 |
| 1265891899 | Counseling Offices of Randy L. Crownover, Lmft, LLC | Community/Behavioral Health | 501 E 15th St, Suite 500a, Edmond, OK 73013-5043 | 2016-02-10 |
| 1710305727 | Jordan Sanchez | Social Worker | 501 E 15th St, Suite 400a, Edmond, OK 73013-5043 | 2014-04-07 |
| 1871923458 | Precision Vision of Edmond, Pllc | Optometrist | 501 E 15th St, Suite 101, Edmond, OK 73013-5043 | 2013-11-19 |
| 1417393836 | Lilyfield, Inc. | Community/Behavioral Health | 501 E 15th St, Ste. 400a, Edmond, OK 73013-5043 | 2013-05-13 |
| 1548408032 | Dixie M. Stewart | Counselor | 501 E 15th St, Suite 102, Edmond, OK 73013-5043 | 2009-01-22 |
| 1235376708 | Paul Silvestri | Counselor | 501 E 15th St, Suite 102, Edmond, OK 73013-5043 | 2009-01-20 |
| 1003071705 | Christian Counseling Associates | Counselor | 501 E 15th St, Suite 102, Edmond, OK 73013-5043 | 2008-07-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407461866 | Alison Church-pugh | Case Manager/Care Coordinator | 1441 Kelley Pointe Pkwy, Edmond, OK 73013 | 2020-09-12 |
| 1699395343 | Dental Specialists of Edmond | Dentist | 16430 Muirfield Pl, Edmond, OK 73013 | 2020-04-23 |
| 1104477215 | Kammerer Richey LLC | Nurse Practitioner | 902 Nw 139th Street Parway, Edmond, OK 73013 | 2019-09-20 |
| 1811459191 | Peak Movement Centre, Pllc | Clinic/Center | 13816 Santa Fe Crossing Dr, Edmond, OK 73013 | 2019-04-04 |
| 1851858492 | Luma Hilal | Pharmacist | 2228 Nw 15th Terrace, Edmond, OK 73013 | 2019-03-01 |
| 1578031571 | Oklahoma Wellness Group LLC | Internal Medicine | 14101 North Esatern Avenue Suite B, Edmond, OK 73013 | 2018-11-07 |
| 1477034395 | Specialty Care Pediatrics, Inc. | Home Health | 2256 Nw 164th Street, Edmond, OK 73013 | 2018-08-28 |
| 1972083921 | Pooja Bhakta | Physician Assistant | Stanbro Healthcare Group LLC, 2000 E. 15th St., Suite 400-a, Edmond, OK 73013 | 2018-08-20 |
| 1417460577 | Oklahoma Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 15103 N Macarthur Blvd, Oklahoma City, OK 73013 | 2017-11-13 |
| 1356879753 | Shawn Smith Optimal Pt and Performance, Pllc | Physical Therapist | 336 Ne 145th Pl, Edmond, OK 73013 | 2017-05-30 |
| Find all providers in zip 73013 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386281186 | Parkside Eyecare, Pllc | Optometrist | 318 S Littler Ave, Edmond, OK 73034-3823 | 2019-11-30 |
| 1699316083 | First Rate Eye Care Pllc | Optometrist | 1140 Nw 192nd St., Suite A, Edmond, OK 73012 | 2019-10-07 |
| 1134552615 | Pinnacle Vision Care Pllc | Optometrist | 15808 Sonador Dr, Edmond, OK 73013-5819 | 2013-08-19 |
| 1770916058 | Elise R Bolay | Optometrist | 833 E 33rd St, Edmond, OK 73013-5407 | 2013-08-09 |
| 1104195825 | Eyesguys LLC | Optometrist | 16135 N May Ave Ste A, Edmond, OK 73013-8977 | 2011-12-27 |
| 1124332846 | Oklahoma Mobile Eye Care Associates | Optometrist | 2805 Nw 158th St, Edmond, OK 73013-8821 | 2010-08-05 |
| 1073744900 | Matthew Edward Morris | Optometrist | 1910 E. 2nd St, Edmond, OK 73034-6250 | 2009-07-27 |
| 1457542060 | Chase Vincent Hunter | Optometrist | 775 W Covell Rd, Ste 140, Edmond, OK 73003-2300 | 2007-08-08 |
| 1386835148 | Matthew P Brooks | Optometrist | 1200 Nw 178th St, Ste 100, Edmond, OK 73012 | 2007-08-07 |
| 1295930410 | Premier Eyecare of Edmond Pllc | Optometrist | 2841 Nw 173rd Street, Edmond, OK 73003 | 2007-06-18 |
| 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.