Richard Wright Schafer, D.O.
Individual provider Active NPI Family Medicine Physician · Bristow, OK
NPI 1164411526 · NPPES record last updated Aug 9, 2023
Key facts
- NPI
- 1164411526
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 3218 (OK)
- Practice address
- 222 N Main St
300 N Main St
Bristow, OK 74010-2408 - Phone
- (918) 367-6533
- Fax
- (918) 367-6544
- NPI assigned
- Oct 18, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080211000016 | OK | Practitioner - Family Practice | 2264515550 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3218 | OK | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| National Family Medical Associates, LLC | Family Medicine | Current |
Accepting new patients |
| Homestead Allergy LLC | Past |
Accepting new patients |
Locations
601 S Harbour Island Blvd
Ste 200
Tampa, FL 33602
Phone (727) 322-3439
300 N Main St
Bristow, OK 74010
Phone (918) 367-6533
7912 E 31st Ct
Ste 220
Tulsa, OK 74145
Phone (352) 572-5457
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 3218 | OK | Yes |
Addresses
Primary practice location
222 N Main St
300 N Main St
Bristow, OK 74010-2408
Mailing address
601 S Harbour Island Blvd Ste 200
Tampa, FL 33602-5925
Phone (800) 480-5243
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200507290A | Medicaid | OK | |
| 100231410A | Medicaid | OK |
Other providers in Bristow, OK
- Jason Dean Remington
- Whitney Richison
- Scott Russell
- Ryan Charles Rychel
- Saint Francis Outreach Services LLC
- Joanne Schroer
- Holly Nicole Shinnen
- Matthew Shockley
- Angela D Skousen
- Carl Roe Smith
All providers in Bristow, OK · Family Medicine Physician in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 9, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.