Organization Active NPI

Reliant Health & Wellness PLLC

  • Family Medicine Physician
  • Enid, OK
National Provider Identifier
1114495785
Registry record updated Sep 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
RELIANT HEALTH & WELLNESS PLLC
Practice address
822 W Randolph Ave
Enid, OK 73701-3834
Phone
(580) 599-0272
Fax
(580) 603-8602
NPI assigned
Nov 12, 2018
Last updated
Sep 19, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2021

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

Authorized official

Name
Jonathan K Bushman, DONPI 1508182619
Title
Owner
Phone
(580) 599-0272

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

822 W Randolph Ave
Enid, OK 73701-3834

Mailing address

822 W Randolph Ave
Enid, OK 73701-3834
Phone (580) 599-0272

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D2160947Reliant Health & Wellness, PLLC822 W Randolph Ave, Enid, OK 73701Certificate of waiverJan 22, 2027

National Provider Directory

National Provider Directory

Locations

915 E Owen K Garriott Rd
Ste J
Enid, OK 73701
Phone (580) 297-5157

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1541980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632009600000",
    "number": "1114495785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "822 W RANDOLPH AVE",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737013834",
            "telephone_number": "580-599-0272",
            "fax_number": "580-603-8602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "822 W RANDOLPH AVE",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737013834",
            "telephone_number": "580-599-0272",
            "fax_number": "580-603-8602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RELIANT HEALTH & WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-12",
        "last_updated": "2021-09-19",
        "certification_date": "2021-09-19",
        "status": "A",
        "authorized_official_last_name": "BUSHMAN",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "580-599-0272",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enid, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.