Active NPI
Ricardo Bernard Madison, B.A.
- Community/Behavioral Health Agency
- Oklahoma City, OK
National Provider Identifier
1104106624
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- License
- 251B00000X
- Practice address
- 1109 NE 59TH St
Oklahoma City, OK 73111-7401 - Phone
- (405) 823-3737
- Fax
- (405) 748-0468
- NPI assigned
- Aug 29, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | 251B00000X | OK | Primary |
Addresses
Primary practice location
1109 NE 59TH St
Oklahoma City, OK 73111-7401
Mailing address
1109 NE 59TH St
Oklahoma City, OK 73111-7401
Phone (405) 823-3737
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
- Credentials
- Bachelor of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 251B00000X | OK | MD | Case Management Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314576000000",
"number": "1104106624",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1109 NE 59TH ST",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731117401",
"telephone_number": "405-823-3737",
"fax_number": "405-748-0468"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1109 NE 59TH ST",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731117401",
"telephone_number": "405-823-3737",
"fax_number": "405-748-0468"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MADISON",
"first_name": "RICARDO",
"middle_name": "BERNARD",
"credential": "B.A.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-08-29",
"last_updated": "2011-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "OK",
"license": "251B00000X",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.