Individual provider Active NPI

Casey Ray Liston, D.O.

  • Emergency Medicine Physician
  • Norman, OK
National Provider Identifier
1295288280
Registry record updated Oct 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
6208 Issued in OK
Practice address
901 N Porter Ave
Norman, OK 73071-6404
Phone
(405) 307-1000
NPI assigned
Jul 26, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 0147R OK
Emergency Medicine Physician 207P00000X 6208 OK Primary

Addresses

Primary practice location

901 N Porter Ave
Norman, OK 73071-6404

Mailing address

3121 Chaucer Dr
Oklahoma City, OK 73120-2206
Phone (405) 802-9683

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
I20171009001852 OK Practitioner - Emergency Medicine 4688949118 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Exceptional Physicians Group Ardmore Hospital PLLCGroup PAC ID 8921542622, 22 clinicians
Mercy Clinic Oklahoma CommunitiesGroup PAC ID 1153468921, 645 clinicians

Practice addresses (Care Compare)

1641 Woerz Way
Ardmore, OK 73401-5071
Phone (436) 341-7800

430 N Monte Vista St
Ada, OK 74820-4610
Phone (580) 332-2323

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0147ROKMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Oklahoma Communities CurrentSince Aug 3, 2020 Accepting new patients
Exceptional Physicians Group Ardmore Hospital PLLC Emergency Medicine CurrentSince Jan 17, 2026 Accepting new patients
Mercy Hospital Logan County, Inc CurrentSince Jan 15, 2018 Accepting new patients
Mercy Hospital Logan County Inc Current Accepting new patients
Mercy Hospital Kingfisher, Inc CurrentSince Jan 15, 2018 Accepting new patients
Mercy Hospital Logan County, Inc CurrentSince Jan 15, 2018 Accepting new patients
Mercy Hospital Ardmore, Inc. Past Accepting new patients
Ehc Ardmore LLC Past Accepting new patients

Locations

430 N Monte Vista St
Ada, OK 74820
Phone (580) 226-1251

1011 14th Ave NW
Ardmore, OK 73401
Phone (580) 220-6658

200 S Academy Rd
Guthrie, OK 73044
Phone (405) 260-4165

1000 Hospital Dr
Kingfisher, OK 73750
Phone (405) 375-3141

4300 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 752-3962

4300 McAuley Blvd
Oklahoma City, OK 73120
Phone (405) 936-5455

Organizations & group practices 8

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": "1469491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508284800000",
    "number": "1295288280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3121 CHAUCER DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731202206",
            "telephone_number": "405-802-9683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 N PORTER AVE",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730716404",
            "telephone_number": "405-307-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISTON",
        "first_name": "CASEY",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-26",
        "last_updated": "2017-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "0147R",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "6208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norman, OK

Sources for this page

Verify at the official NPI Registry.