Active NPI
Barbara Telisa Grady
- Counselor
- Durant, OK
National Provider Identifier
1275887523
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 1327 N 16TH Ave
Durant, OK 74701-2134 - Phone
- (580) 931-9064
- NPI assigned
- Nov 7, 2012
- Last updated
- Nov 7, 2012
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | NU | Primary |
Addresses
Primary practice location
1327 N 16TH Ave
Durant, OK 74701-2134
Mailing address
815 Gerlach Dr
525
Durant, OK 74701-2562
Phone (580) 775-2304
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200287120A | Medicaid | OK |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1352246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352246400000",
"number": "1275887523",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "815 GERLACH DR",
"address_2": "525",
"city": "DURANT",
"state": "OK",
"postal_code": "747012562",
"telephone_number": "580-775-2304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1327 N 16TH AVE",
"city": "DURANT",
"state": "OK",
"postal_code": "747012134",
"telephone_number": "580-931-9064"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRADY",
"first_name": "BARBARA",
"middle_name": "TELISA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-11-07",
"last_updated": "2012-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200287120A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Durant, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.