NPIMap

Individual provider Active NPI

Bradley Todd Anderson, DO

  • Family Medicine Physician
  • Coweta, OK
National Provider Identifier
1023058757
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
3893 Issued in OK
Practice address
28622 E 141St St S
Coweta, OK 74429-7515
Phone
(918) 486-7425
Fax
(918) 279-6884
NPI assigned
Jun 8, 2006
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 3893 OK Primary

Addresses

Primary practice location

28622 E 141St St S
Coweta, OK 74429-7515

Mailing address

28622 E 141St St S
PO Box 1030
Coweta, OK 74429-7515
Phone (918) 486-7425

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040524000871 OK Practitioner - Family PracticePractitioner - Emergency Medicine 2062403371 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Oklahoma State University College of Osteopathic Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Coweta Medical Group,P.L.L.C.Group PAC ID 2466501069, 4 clinicians

Practice addresses (Care Compare)

28622 E 141St S St
Coweta, OK 74429-7515
Phone (918) 486-7425

28622 E 141St St S
Coweta, OK 74429-7515

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
3893OKMDFamily Medicine Physician
3983OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Coweta Medical Group,P.L.L.C. CurrentSince Apr 12, 2009 Accepting new patients
Urgent Care of Green Country PLLC Past Accepting new patients

Locations

28622 E 141st St S
Coweta, OK 74429
Phone (918) 486-7425

Organizations & group practices 2

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1023058757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28622 E 141ST ST S",
            "address_2": "PO BOX 1030",
            "city": "COWETA",
            "state": "OK",
            "postal_code": "744297515",
            "telephone_number": "918-486-7425",
            "fax_number": "918-279-6884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28622 E 141ST ST S",
            "city": "COWETA",
            "state": "OK",
            "postal_code": "744297515",
            "telephone_number": "918-486-7425",
            "fax_number": "918-279-6884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "BRADLEY",
        "middle_name": "TODD",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "3893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coweta, OK

Sources for this page

Verify at the official NPI Registry.