Blue Bayou Inc

Primary specialty

Adolescent Medicine (Family Medicine) PhysicianTaxonomy code 207QA0000X

License

12345 Issued in OK

Legal business name

BLUE BAYOU INC

Practice address

100 Park Ave
Oklahoma City, OK 73102-8006

Phone

(405) 229-3410

NPI assigned

Aug 15, 2012

Last updated

Sep 18, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

James Bronson

Title

Ceo

Phone

(405) 229-3410

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1344988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347926400000",
    "number": "1043568538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PARK AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731028006",
            "telephone_number": "405-229-3410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PARK AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731028006",
            "telephone_number": "405-229-3410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE BAYOU INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-15",
        "last_updated": "2012-09-18",
        "status": "A",
        "authorized_official_last_name": "BRONSON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "405-229-3410"
    },
    "taxonomies": [
        {
            "code": "207QA0000X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": "OK",
            "license": "12345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Arden Blough, M.D.
• Alan Craig Blount Jr., BHRS
• Rachel Elizabeth Blount, BHRS
• Samuel Blount
• Ryan Thomas Blucker
• Blue Star Medical Group PLLC
• Barney E Blue, DO
• Jennifer Fons Blue, MS, LPC
• Bluebird Counseling LLC
• Bluestar CMB Incorporated

• Adolescent Medicine (Family Medicine) Physician in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Adolescent Medicine (Family Medicine) Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.