Active NPI
Bryan D Adams, DPH.
- Pharmacist
- Mannford, OK
National Provider Identifier
1164539623
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 10957
- Practice address
- 124 Coonrod Ave
Mannford, OK 74044-3437 - Phone
- (918) 865-2164
- NPI assigned
- Aug 23, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 10957 | OK | Primary |
Addresses
Primary practice location
124 Coonrod Ave
Mannford, OK 74044-3437
Mailing address
PO Box 971
Mannford, OK 74044-0971
Phone (918) 865-2164
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 |
|---|---|---|---|
| 10957 | OK | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baltro LLC | Past | Accepting new patients | |
| Baltro LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1164539623",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 971",
"city": "MANNFORD",
"state": "OK",
"postal_code": "740440971",
"telephone_number": "918-865-2164"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "124 COONROD AVE",
"city": "MANNFORD",
"state": "OK",
"postal_code": "740443437",
"telephone_number": "918-865-2164"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADAMS",
"first_name": "BRYAN",
"middle_name": "D",
"credential": "DPH.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OK",
"license": "10957",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mannford, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.