Individual provider Active NPI

Bryan Cain

  • Podiatrist
  • Lawton, OK
National Provider Identifier
1336284595
Registry record updated Mar 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
153 Issued in OK
Practice address
5101 SW Lee Blvd
Lawton, OK 73505-8317
Phone
(580) 357-8720
Fax
(580) 357-8759
NPI assigned
Feb 21, 2007
Last updated
Mar 10, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 153 OK Primary

Addresses

Primary practice location

5101 SW Lee Blvd
Lawton, OK 73505-8317

Mailing address

5101 SW Lee Blvd
Lawton, OK 73505-8317
Phone (580) 357-8720

Other identifiers 1

IdentifierTypeStateIssuer
731182936001OtherBCBS

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080515000615 OK Practitioner - Podiatry 4284703331 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oklahoma Mobile Podiatry Services LLCGroup PAC ID 4385086206, 2 clinicians

Practice addresses (Care Compare)

2300 S Broadway
Suite 110
Edmond, OK 73013-4065
Phone (405) 285-8900

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue1029
Removal or shaving of skin growth319

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
153OKMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
John K Cauthon D P M Current Accepting new patients
Oklahoma Mobile Podiatry Services LLC CurrentSince Sep 1, 2024 Accepting new patients
Wichita Medical Anesthesia LLC PastSince Jul 1, 2020 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Tulsa Podiatry Clinics LLC Podiatrist PastSince Apr 21, 2026 Accepting new patients

Locations

2300 S Broadway
Ste 110
Edmond, OK 73013
Phone (405) 209-0322

Organizations & group practices 6

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": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205107200000",
    "number": "1336284595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5101 SW LEE BLVD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735058317",
            "telephone_number": "580-357-8720",
            "fax_number": "580-357-8759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5101 SW LEE BLVD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735058317",
            "telephone_number": "580-357-8720",
            "fax_number": "580-357-8759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAIN",
        "first_name": "BRYAN",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2008-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OK",
            "license": "153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "731182936001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawton, OK

Sources for this page

Verify at the official NPI Registry.