NPIMap

Individual provider Active NPI

Conager Ray McBroom

  • Physician Assistant
  • Broken Bow, OK
National Provider Identifier
1184582546
Registry record updated Jan 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1300 E Martin Luther King Dr
Broken Bow, OK 74728-4160
Phone
(580) 208-2204
NPI assigned
Jan 14, 2026
Last updated
Jan 14, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X OK Primary

Addresses

Primary practice location

1300 E Martin Luther King Dr
Broken Bow, OK 74728-4160

Mailing address

1300 E Martin Luther King Dr
Broken Bow, OK 74728-4160

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260209002065 TX Practitioner - Physician Assistant 9335628551 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Choctaw Nation of OklahomaGroup PAC ID 1759294838, 271 clinicians

Practice addresses (Care Compare)

1300 E Martin Luther King Dr
Broken Bow, OK 74728-4160
Phone (918) 567-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5798OKMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Choctaw Nation of Oklahoma CurrentSince Feb 2, 2026 Accepting new patients
Choctaw Nation of Oklahoma CurrentSince Feb 2, 2026 Accepting new patients

Locations

1585 W Liberty Rd
Atoka, OK 74525
Phone (580) 889-1981

1300 E Martin Luther King Dr
Broken Bow, OK 74728
Phone (580) 208-2204

410 N M St
Hugo, OK 74743
Phone (580) 326-7561

902 E Lincoln Rd
Idabel, OK 74745
Phone (580) 286-2600

1127 S George Nigh Expy
McAlester, OK 74501
Phone (918) 423-8440

109 Kerr Blvd
Poteau, OK 74953
Phone (918) 649-1100

2204 E Main St
Stigler, OK 74462
Phone (918) 967-9200

1 Choctaw Way
Talihina, OK 74571
Phone (918) 423-8440

205 Dallas St
Talihina, OK 74571
Phone (918) 567-3636

Organizations & group practices 3

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.

Hospital & facility affiliations 11

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

NPI Registry JSON

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

{
    "created_epoch": "1768348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768348800000",
    "number": "1184582546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 E MARTIN LUTHER KING DR",
            "city": "BROKEN BOW",
            "state": "OK",
            "postal_code": "747284160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 E MARTIN LUTHER KING DR",
            "city": "BROKEN BOW",
            "state": "OK",
            "postal_code": "747284160",
            "telephone_number": "580-208-2204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCBROOM",
        "first_name": "CONAGER",
        "middle_name": "RAY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-01-14",
        "last_updated": "2026-01-14",
        "certification_date": "2026-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broken Bow, OK

Sources for this page

Verify at the official NPI Registry.