Individual provider Active NPI

Joshua J. Livingston, D.O.

  • Pain Medicine Physician
  • Broken Arrow, OK
National Provider Identifier
1245220839
Registry record updated May 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
4209 Issued in OK
Practice address
2033 W Houston St
Broken Arrow, OK 74012-8304
Phone
(918) 743-3636
Fax
(918) 743-3663
NPI assigned
Oct 25, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine Physician 208VP0000X 4209 OK Primary

Addresses

Primary practice location

2033 W Houston St
Broken Arrow, OK 74012-8304

Mailing address

2033 W Houston St
Broken Arrow, OK 74012-8304
Phone (918) 743-3636

Other identifiers 1

IdentifierTypeStateIssuer
200031520AMedicaidOK

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)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
4209OKMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Sterling Emergency Services of Oklahoma, Inc. Past Accepting new patients
Okmulgee Emergency PLLC Past Accepting new patients
Green Country Emergency Physicians Group of Tulsa PLLC Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400457600000",
    "number": "1245220839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2033 W HOUSTON ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740128304",
            "telephone_number": "918-743-3636",
            "fax_number": "918-743-3663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2033 W HOUSTON ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740128304",
            "telephone_number": "918-743-3636",
            "fax_number": "918-743-3663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVINGSTON",
        "first_name": "JOSHUA",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-25",
        "last_updated": "2014-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "OK",
            "license": "4209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200031520A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Broken Arrow, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2014; 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.