Brian Gillam Birdwell, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

13900 Issued in OK

Practice address

4202 SW Lee Blvd
Lawton, OK 73505-8300

Phone

(580) 248-9966

Fax

(580) 248-8313

NPI assigned

Aug 18, 2005

Last updated

Dec 22, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Previously, effective Oct 1, 2014 through Oct 1, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: brian.birdwell@16403398590468.direct.elationemr.com
• FHIR API: https://api.platform.athenahealth.com/1821/brand/1/csg/22/fhir/r4

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.

• Brian Birdwell MD PC

  dba Birdwell-Ferris Clinic

  • Internal Medicine Physician
  • Lawton, OK
  • NPI 1174684765
  Authorized official Same address or phone
• Jackson County Memorial Hospital Authority

  • General Acute Care Hospital
  • Altus, OK
  • NPI 1093763781
  NPD (past)
• McBride Clinic Inc

  • Orthopaedic Surgery Physician
  • Oklahoma City, OK
  • NPI 1053319889
  NPD (past)
• Southern Oklahoma Infectious Diseases Consultants, PC

  • Infectious Disease Physician
  • Lawton, OK
  • NPI 1922296805
  NPD (past)
• Southwestern Surgical Affiliates, LLC

  • Orthopaedic Surgery Physician
  • Lawton, OK
  • NPI 1013169531
  NPD (past)

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324512000000",
    "number": "1013909605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4202 SW LEE BLVD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735058300",
            "telephone_number": "580-248-9966",
            "fax_number": "580-248-8313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4202 SW LEE BLVD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735058300",
            "telephone_number": "580-248-9966",
            "fax_number": "580-248-8313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIRDWELL",
        "first_name": "BRIAN",
        "middle_name": "GILLAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2011-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "13900",
            "primary": true
        },
        {
            "code": "2083P0011X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "OK",
            "license": "13900",
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "OK",
            "license": "13900",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100824240",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Teresa Biffle, LBP
• Brian John Bigelow, PH.D., ABPP
• Shannon Bighair
• Karen T. Bill
• Tanisha Billingslea, PH.D
• Daryl E Birdwell, M.D.
• Bette J. Bischoff Glidewell, MD
• Laura Bishop
• Marquise Lushuan Bishop, BS
• Kelli Bissell

• Internal Medicine Physician in Lawton, OK
• Providers in Lawton, OK by specialty
• Internal Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.