Individual provider Active NPI

Brandon Duane Stone, BACHELORS OF ARTS

  • Rehabilitation Psychologist
  • Poteau, OK
National Provider Identifier
1184094914
Registry record updated Oct 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PsychologistTaxonomy code 103TR0400X
License
J082273380 Issued in OK
Practice address
1011 N Broadway St
Poteau, OK 74953-2609
Phone
(918) 649-0011
NPI assigned
Oct 6, 2015
Last updated
Oct 6, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Psychologist 103TR0400X J082273380 OK Primary

Addresses

Primary practice location

1011 N Broadway St
Poteau, OK 74953-2609

Mailing address

17161 Old Highway 112
Poteau, OK 74953-7554
Phone (918) 413-9024

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

LicenseStateTypeSpecialty
J082273380OKMDRehabilitation Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Oklahoma Mental Health & Counseling LLC 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, 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": "1444089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444089600000",
    "number": "1184094914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17161 OLD HIGHWAY 112",
            "city": "POTEAU",
            "state": "OK",
            "postal_code": "749537554",
            "telephone_number": "918-413-9024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 N BROADWAY ST",
            "city": "POTEAU",
            "state": "OK",
            "postal_code": "749532609",
            "telephone_number": "918-649-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STONE",
        "first_name": "BRANDON",
        "middle_name": "DUANE",
        "credential": "BACHELORS OF ARTS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-06",
        "last_updated": "2015-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "OK",
            "license": "J082273380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poteau, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.

Verify at the official NPI Registry.