William Earl Tankersley IV, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

24016 Issued in OK

Practice address

604 S Classen Ave
Suite C
Moore, OK 73160-5401

Phone

(405) 799-0900

Fax

(405) 799-0902

NPI assigned

Sep 28, 2006

Last updated

Apr 29, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. William Earl Tankersley IV Former name

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• State of Oklahoma

  dba Central Oklahoma Community Mental Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Norman, OK
  • NPI 1588755532
  Medicare reassignment NPD
• Uhs Oklahoma City LLC

  dba Cedar Ridge Behavioral Hospital

  • Psychiatry Physician
  • Oklahoma City, OK
  • NPI 1083985600
  Medicare reassignment NPD
• William E Tankersley MD PLLC

  • Psychiatry Physician
  • Moore, OK
  • NPI 1366616526
  Authorized official Same address or phone
• State of Oklahoma

  • Skilled Nursing Facility
  • Talihina, OK
  • NPI 1154589430
  NPD
• State of Oklahoma

  dba Northwest Center for Behavioral Health

  • Psychiatric Hospital
  • Fort Supply, OK
  • NPI 1922171701
  NPD
• Uhs Oklahoma City LLC

  dba Cedar Ridge

  • Psychiatric Hospital
  • Oklahoma City, OK
  • NPI 1598716490
  NPD (past)

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209427200000",
    "number": "1053402347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7411",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731531411",
            "telephone_number": "405-799-0900",
            "fax_number": "405-799-0902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 S CLASSEN AVE",
            "address_2": "SUITE C",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731605401",
            "telephone_number": "405-799-0900",
            "fax_number": "405-799-0902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANKERSLEY",
        "first_name": "WILLIAM",
        "middle_name": "EARL",
        "name_suffix": "IV",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2008-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OK",
            "license": "24016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WILLIAM",
            "last_name": "TANKERSLEY",
            "middle_name": "EARL",
            "prefix": "DR.",
            "suffix": "IV",
            "credential": "M D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Nathan L Tate
• Andrea Brooke Taylor
• Celeste A Taylor, M.S. CCC-SLP
• Harry B. Taylor, PA-C
• Hayli Taylor

• Psychiatry Physician in Moore, OK
• Providers in Moore, OK by specialty
• Psychiatry Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.