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SHAWNEE VISION SOURCE
NPI 1104228105
Optometrist in Shawnee, OK

Active since September 22, 2014
100 E 45TH ST, SHAWNEE, OK 74804(405) 275-7676(405) 275-6837 Get Directions Write a Review

NPPES record last updated: September 22, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Shawnee Vision Source NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHAWNEE VISION SOURCE (NPI 1104228105) is a healthcare organization registered as an optometrist in Shawnee, Oklahoma and active in the NPI registry since September 2014. The organization lists Trevor Conklin, Owner/partner, as its authorized official.

NPPES Registry Identity

NPI1104228105
Entity TypeOrganization
Primary Taxonomy152W00000X
Legal Business NameSHAWNEE EYE ASSOCIATES, PLLC
Location Address100 E 45TH STShawnee, OK 74804-1439
Mailing Address100 E 45th StShawnee, OK 74804-1439 · (405) 275-7676 · Fax (405) 275-6837
Phone(405) 275-7676
Fax(405) 275-6837
Organization SubpartNo
Authorized OfficialTrevor ConklinOwner/partner · (405) 275-7676
Enumeration DateSeptember 22, 2014
✔ NPI 1104228105 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in OK · 2690
Definition
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.
100 E 45TH ST, Shawnee, OK 74804
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Other Names 1

Doing Business AsShawnee Vision Source

Other Identifiers 1

Medicaid200350320AOK

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of Tennessee.Insurance ›

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MARSHALL R GLECKLER O. D.
Optometrist
100 E 45TH ST
SHAWNEE, OK 74804
Pottawatomie County (405) 275-7676
BRIANNA WEBER OD
Optometrist
100 E 45TH ST
SHAWNEE, OK 74804
Pottawatomie County (405) 275-7676
BRITTON ADAMS OD
Optometrist
100 E 45TH ST
SHAWNEE, OK 74804
Pottawatomie County (405) 275-7676
DR. TRAVIS RYAN KLIEWER O.D.
Optometrist
100 E 45TH ST
SHAWNEE, OK 74804
Pottawatomie County (405) 275-7676
MARSHALL R GLECKLER OD PLLC
Optometrist
100 E 45TH ST
SHAWNEE, OK 74804
Pottawatomie County (405) 275-7676

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shawnee Eye Associates, PLLC's NPI number?

The NPI number for Shawnee Eye Associates, PLLC is 1104228105. It was assigned to this organization in the NPPES registry on September 22, 2014. The provider is doing business as Shawnee Vision Source.

Where is Shawnee Eye Associates, PLLC located?

Shawnee Eye Associates, PLLC is located at 100 E 45th St, Shawnee, OK 74804. The listed phone number is (405) 275-7676.

What is Shawnee Eye Associates, PLLC's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

What insurance does Shawnee Eye Associates, PLLC accept?

Health plans from BlueCross BlueShield of Tennessee list Shawnee Eye Associates, PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Shawnee Eye Associates, PLLC was last updated on September 22, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.