Bethany Medical Clinic, PLLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

9222 Issued in OK

Legal business name

BETHANY MEDICAL CLINIC, PLLC

Practice address

6801 NW 39TH Expy
Bethany, OK 73008-2501

Phone

(405) 789-2441

NPI assigned

Aug 5, 2007

Last updated

Aug 31, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Douglas W. Brant, M.D.NPI 1780618108

Title

Owner

Phone

(405) 789-2441

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/18646/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Douglas Wayne Brant Sr., M.D.

  • Family Medicine Physician
  • Bethany, OK
  • NPI 1780618108
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598832000000",
    "number": "1255522306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6801 NW 39TH EXPY",
            "city": "BETHANY",
            "state": "OK",
            "postal_code": "730082501",
            "telephone_number": "405-789-2441",
            "fax_number": "405-789-7978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 NW 39TH EXPY",
            "city": "BETHANY",
            "state": "OK",
            "postal_code": "730082501",
            "telephone_number": "405-789-2441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHANY MEDICAL CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-05",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A",
        "authorized_official_last_name": "BRANT",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-789-2441",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "OK",
            "license": "9222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR GROUP",
            "identifier": "CH9820",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Antonia Angeline Benton, REGISTERED NURSE
• Collin Michael Berkman
• Kali Bernhard, M.A., CCC-SLP
• Bethany Dental Group PLLC (Bethany Dental Group)
• Bethany Foot Clinic LTD
• Bethany Perfusion, PC
• Bethany Public Schools
• Bethany United Drug Co (Bethany Drug)
• Tanya Billingsley
• Rachel Blevins

• Health Service Clinic/Center in Bethany, OK
• Providers in Bethany, OK by specialty
• Health Service Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.