Lawrence Clay Brotherton III, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

24398 Issued in OK

Practice address

1725 E 19TH St
Suite 800
Tulsa, OK 74104-5472

Phone

(918) 301-2505

Fax

(918) 744-3633

NPI assigned

Oct 11, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lawrence.brotherton@direct.stjohnhealthsystem.com

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.

• St. John Physicians, Inc.

  • Internal Medicine Physician
  • Tulsa, OK
  • NPI 1336194406

  OK

  Medicare reassignment Care Compare group NPD
• St. John Physicians, Inc

  • Rural Health Clinic/Center
  • Barnsdall, OK
  • NPI 1033176367
  Care Compare group NPD
• St. John Physicians, Inc

  • Rural Health Clinic/Center
  • Coffeyville, KS
  • NPI 1669792818
  Care Compare group
• St. John Physicians, Inc

  • Rural Health Clinic/Center
  • Caney, KS
  • NPI 1912961418
  Care Compare group
• Owasso Medical Facility, Inc

  • General Acute Care Hospital
  • Owasso, OK
  • NPI 1144231432
  NPD (past)
• St John Medical Center Inc

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1154417368
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Owasso Medical Facility, Inc

  • General Acute Care Hospital
  • Owasso, OK
  • NPI 1144231432

  Hospital

  Care Compare affiliation
• St John Medical Center Inc

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1154417368

  Hospital

  Care Compare affiliation
• St John Medical Center Inc

  • Rehabilitation Hospital Unit
  • Tulsa, OK
  • NPI 1578656161

  Hospital

  Care Compare affiliation

Specialty

General Surgery

Education

University of Kansas School of Med (KC/Wich/Sal), 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St. John Physicians, Inc. 262 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St John Owasso Hospital, Owasso, OK, CCN 370227
• Ascension St John Medical Center Hospital, Tulsa, OK, CCN 370114

Procedures performed for Medicare patients

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311638400000",
    "number": "1144218322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 E 19TH ST",
            "address_2": "SUITE 800",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045472",
            "telephone_number": "918-301-2505",
            "fax_number": "918-744-3633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 E 19TH ST",
            "address_2": "SUITE 800",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045472",
            "telephone_number": "918-301-2505",
            "fax_number": "918-744-3633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROTHERTON",
        "first_name": "LAWRENCE",
        "middle_name": "CLAY",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-11",
        "last_updated": "2011-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OK",
            "license": "24398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PIN",
            "identifier": "730768966",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200060600A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Haley Marie Brooner, CM
• Jimmie Lee Brooner, DPH
• Virginia Ann Brophy, PT
• Maren Brose, LCSW
• Shana Rochelle Brothers, BA, AA, AS
• Michelle C Brotherton, MD
• Ronald Clark Broughton, LPC
• Monica Broussard, P.A. - C
• Megan R Brown Harris, PSYD
• Brown Token Behavior LLC

• All providers in Tulsa, OK
• Surgery Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.