NPIMap

Individual provider Active NPI

Wyatt-Dean Avery Pickering, D.O.

  • Emergency Medicine Physician
  • Tulsa, OK
National Provider Identifier
1316178874
Registry record updated Aug 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
4799 Issued in OK
Practice address
1223 S Lawton Ave
Tulsa, OK 74127-9173
Phone
(918) 510-4534
NPI assigned
Aug 1, 2009
Last updated
Aug 1, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4799 OK Primary

Addresses

Primary practice location

1223 S Lawton Ave
Tulsa, OK 74127-9173

Mailing address

1223 S Lawton Ave
Tulsa, OK 74127-9173
Phone (918) 510-4534

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140822000752 MO Practitioner - Emergency Medicine 8325194145 Reassigns benefits to 8 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4799OKMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Harrison County Community Hospital District Current Accepting new patients
Saint Luke's Hospital of Trenton CurrentSince Jul 1, 2025 Accepting new patients
General John J Pershing Memorial Hospital Association CurrentSince Jun 18, 2023 Accepting new patients
Saint Lukes Hospital of Chillicothe CurrentSince Jul 1, 2025 Accepting new patients
Harrison County Community Hospital District CurrentSince Mar 1, 2025 Accepting new patients
Saint Luke's Hospital of Trenton Emergency Medicine CurrentSince Jan 19, 2019 Accepting new patients
Saint Lukes Hospital of Chillicothe CurrentSince Jul 16, 2014 Accepting new patients
Harrison County Community Hospital District CurrentSince Mar 1, 2025 Accepting new patients
General John J Pershing Memorial Hospital Association CurrentSince Jun 18, 2023 Accepting new patients
Saint Luke's Hospital of Trenton CurrentSince Jan 19, 2019 Accepting new patients
Saint Lukes Hospital of Chillicothe Emergency Medicine CurrentSince Jul 16, 2014 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Washita Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Hughes Emergency Physicians Emergency Medicine Past Accepting new patients
Jackson County Memorial Hospital Authority PastSince Dec 31, 2008 Accepting new patients
Purcell Emergency PLLC Emergency Medicine Past Accepting new patients

Locations

2600 Miller St
Bethany, MO 64424
Phone (660) 425-2211

130 E Lockling St
Brookfield, MO 64628
Phone (660) 258-1050

2799 N Washington St
Chillicothe, MO 64601
Phone (660) 214-8300

191 Iowa Blvd
Trenton, MO 64683
Phone (660) 358-5700

Interoperability endpoints

  • FHIR API: https://epicmobile.corp.saint-lukes.org/FHIRPROXY/api/FHIR/R4

Organizations & group practices 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1249084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249084800000",
    "number": "1316178874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1223 S LAWTON AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741279173",
            "telephone_number": "918-510-4534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1223 S LAWTON AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741279173",
            "telephone_number": "918-510-4534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICKERING",
        "first_name": "WYATT-DEAN",
        "middle_name": "AVERY",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-01",
        "last_updated": "2009-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "4799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.