Individual provider Active NPI

Russell Bruce Parker, MD

  • Obstetrics Physician
  • Norman, OK
National Provider Identifier
1205844420
Registry record updated Jun 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
License
15169 Issued in OK
Practice address
3441 24TH Ave NW Ste 105
Norman, OK 73069-6716
Phone
(405) 321-2929
Fax
(405) 366-8701
NPI assigned
Aug 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 15169 OK
Obstetrics Physician 207VX0000X 15169 OK Primary

Addresses

Primary practice location

3441 24TH Ave NW Ste 105
Norman, OK 73069-6716

Mailing address

3441 24TH Ave NW Ste 105
Norman, OK 73069-6716
Phone (140) 532-1292

Other identifiers 1

IdentifierTypeStateIssuer
100147560AMedicaidOK

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20090420000418 OK Practitioner - Obstetrics/Gynecology 1557418076 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Texas Medical Branch at Galveston, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3441 24TH Ave NW
105 R Bruce Parker MD
Norman, OK 73069-6716
Phone (405) 321-2929

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
R Bruce Parker MD PC Specialist CurrentSince Apr 1, 2009 Accepting new patients
Norman Regional Hospital Authority Past Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients

Locations

3441 24th Ave NW
Ste 105
Norman, OK 73069
Phone (405) 321-2929

1407 N Porter Ave
Norman, OK 73071
Phone (405) 329-4304

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IGCICA/Endpoint/IGCICA

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1205844420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3441 24TH AVE NW STE 105",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730696716",
            "telephone_number": "140-532-1292",
            "fax_number": "405-366-8701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3441 24TH AVE NW STE 105",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730696716",
            "telephone_number": "405-321-2929",
            "fax_number": "405-366-8701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "RUSSELL",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OK",
            "license": "15169",
            "primary": false
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "OK",
            "license": "15169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100147560A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norman, OK

Sources for this page

Verify at the official NPI Registry.