Active NPI
Kathryn Buchanan, MASTERS IN COUNSELIN
- Counselor
- Grove, OK
National Provider Identifier
1134450562
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 4614
- Practice address
- 1115 Harbor Rd
Grove, OK 74344-3505 - Phone
- (918) 786-4434
- Fax
- (918) 786-4435
- NPI assigned
- Jan 25, 2010
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 4614 | OK | Primary |
Addresses
Primary practice location
1115 Harbor Rd
Grove, OK 74344-3505
Mailing address
1115 Harber Rd
Grove, OK 74344-3505
Phone (918) 786-4434
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 731013488 | 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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4614 | OK | MD | Pediatric Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grand Lake Mental Health Center, Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Tulsa, OK
- NPI 1356048656
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1264377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1446422400000",
"number": "1134450562",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1115 HARBER RD",
"city": "GROVE",
"state": "OK",
"postal_code": "743443505",
"telephone_number": "918-786-4434",
"fax_number": "918-786-4435"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1115 HARBOR RD",
"city": "GROVE",
"state": "OK",
"postal_code": "743443505",
"telephone_number": "918-786-4434",
"fax_number": "918-786-4435"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUCHANAN",
"first_name": "KATHRYN",
"credential": "MASTERS IN COUNSELIN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-01-25",
"last_updated": "2015-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "OK",
"license": "4614",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "731013488",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grove, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.