Active NPI
Bernie B Wyatt
- Pharmacist
- Okemah, OK
National Provider Identifier
1245384361
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 8862
- Practice address
- 324 W Broadway St
Okemah, OK 74859-2608 - Phone
- (918) 623-1771
- Fax
- (918) 623-0238
- NPI assigned
- Jan 23, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | 8862 | OK | Primary |
Addresses
Primary practice location
324 W Broadway St
Okemah, OK 74859-2608
Mailing address
324 W Broadway St
Okemah, OK 74859-2608
Phone (918) 623-1036
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 |
|---|---|---|---|
| 8862 | OK | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sooner Drug and Gifts Or Okemah | 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": "1169510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1245384361",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "324 W BROADWAY ST",
"city": "OKEMAH",
"state": "OK",
"postal_code": "748592608",
"telephone_number": "918-623-1036",
"fax_number": "918-623-0238"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "324 W BROADWAY ST",
"city": "OKEMAH",
"state": "OK",
"postal_code": "748592608",
"telephone_number": "918-623-1771",
"fax_number": "918-623-0238"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYATT",
"first_name": "BERNIE",
"middle_name": "B",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OK",
"license": "8862",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Okemah, 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.