Individual provider Active NPI

Bryan Nutter, ARNP

  • Nurse Practitioner
  • Alva, OK
National Provider Identifier
1023130689
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1775053 Issued in OK
Practice address
800 Share Dr
Alva, OK 73717-3618
Phone
(580) 327-2800
NPI assigned
Apr 4, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1775053 OK Primary

Addresses

Primary practice location

800 Share Dr
Alva, OK 73717-3618

Mailing address

800 Share Dr
Alva, OK 73717-3618

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050203000371 OK Practitioner - Nurse Practitioner 5092765081 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alva Hospital AuthorityGroup PAC ID 5597755306, 14 clinicians

Practice addresses (Care Compare)

800 Share Dr
Alva, OK 73717-3618
Phone (580) 430-3366

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
64.87 of 100Reported as group
Quality
33.38
Promoting interoperability
79
Improvement activities
40
Cost
67.03

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1775053OKMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alva Hospital Authority/Dba Share Medical Center CurrentSince Oct 31, 2003 Accepting new patients
Alva Hospital Authority CurrentSince Oct 31, 2003 Accepting new patients
Alva Hospital Authority Current Accepting new patients
Vision Park Family Eye Care, LLP PastSince Jan 1, 2000 Accepting new patients
Summit Medical Center Past Accepting new patients
Vision Park Family Eye Care Past Accepting new patients

Locations

410 4th St
Ste G
Alva, OK 73717
Phone (580) 327-5442

410 4th St
Ste J
Alva, OK 73717
Phone (580) 430-3333

800 Share Dr
Alva, OK 73717
Phone (580) 327-2800

Organizations & group practices 6

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 1

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": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023130689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 SHARE DR",
            "city": "ALVA",
            "state": "OK",
            "postal_code": "737173618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 SHARE DR",
            "city": "ALVA",
            "state": "OK",
            "postal_code": "737173618",
            "telephone_number": "580-327-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUTTER",
        "first_name": "BRYAN",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OK",
            "license": "1775053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alva, OK

Sources for this page

Verify at the official NPI Registry.