Active NPI
David Wakefield
- Psychologist
- Tulsa, OK
National Provider Identifier
1073050308
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 682
- Practice address
- 6655 S Yale Ave
Tulsa, OK 74136-3326 - Phone
- (918) 491-3700
- Fax
- (918) 481-4063
- NPI assigned
- Jan 25, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 268 | OK | |
| Psychologist | 103T00000X | 682 | OK | Primary |
Addresses
Primary practice location
6655 S Yale Ave
Tulsa, OK 74136-3326
Mailing address
PO Box 707001
Tulsa, OK 74170-7001
Phone (888) 247-0125
Other practice location 1
7205 S Ash Pl
Broken Arrow, OK 74011-6810
Phone (918) 637-7000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100842120A | Medicaid | OK |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 268 | OK | MD | Physical Therapy Assistant |
| 682 | OK | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1485302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643328000000",
"number": "1073050308",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 707001",
"city": "TULSA",
"state": "OK",
"postal_code": "741707001",
"telephone_number": "888-247-0125",
"fax_number": "918-502-8001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6655 S YALE AVE",
"city": "TULSA",
"state": "OK",
"postal_code": "741363326",
"telephone_number": "918-491-3700",
"fax_number": "918-481-4063"
}
],
"practiceLocations": [
{
"address_1": "7205 S Ash Pl",
"address_purpose": "LOCATION",
"city": "Broken Arrow",
"state": "OK",
"postal_code": "740116810",
"country_code": "US",
"telephone_number": "918-637-7000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WAKEFIELD",
"first_name": "DAVID",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-01-25",
"last_updated": "2022-01-28",
"certification_date": "2022-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "OK",
"license": "268",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "OK",
"license": "682",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100842120A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.