Individual provider Active NPI

Sheryl Johnson-Bryan

  • Counselor
  • Duncan, OK
National Provider Identifier
1053869321
Registry record updated Sep 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
16 S 7TH St
Duncan, OK 73533-4940
Phone
(580) 255-8800
NPI assigned
Sep 15, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

16 S 7TH St
Duncan, OK 73533-4940

Mailing address

14 NW 28TH St
Lawton, OK 73505-6214

Other identifiers 1

IdentifierTypeStateIssuer
100731690MedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1473897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473897600000",
    "number": "1053869321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 NW 28TH ST",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 S 7TH ST",
            "city": "DUNCAN",
            "state": "OK",
            "postal_code": "735334940",
            "telephone_number": "580-255-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON-BRYAN",
        "first_name": "SHERYL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-15",
        "last_updated": "2016-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100731690",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duncan, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2016; 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.