Landre Tatum Oglesby, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2000029828

Practice address

100 N University Dr # 190
Edmond, OK 73034-5207

Phone

(405) 974-2188

NPI assigned

Jul 14, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1499990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1043732787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13616 RED BUD RD",
            "city": "CHOCTAW",
            "state": "OK",
            "postal_code": "730207166",
            "telephone_number": "405-250-0550",
            "fax_number": "405-250-0550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N UNIVERSITY DR # 190",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730345207",
            "telephone_number": "405-974-2188"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13616 Red Bud Rd",
            "address_purpose": "LOCATION",
            "city": "Choctaw",
            "state": "OK",
            "postal_code": "730207166",
            "country_code": "US",
            "telephone_number": "405-250-0550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OGLESBY",
        "first_name": "LANDRE",
        "middle_name": "TATUM",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-14",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": "2000029828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF CERTIFICATION",
            "identifier": "73898",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Neadum Brett Odum, D.C.
• Adebowale Folorunso Odusote
• David Ogden
• Madelyn Ogle, MA CCC-SLP
• Jonathan Oglesby, BHRS
• Oyefunke Abidemi Ogunbanwo
• Alexander Ogunseye, COTA/L
• Sally Oh
• Ok Oms Specialty Dental Services, PLLC
• Ok Psych NP LLC

• Athletic Trainer in Edmond, OK
• Providers in Edmond, OK by specialty
• Athletic Trainer in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.