Elan Josiah Eagle

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

Practice address

470819 E 810 Rd
Stilwell, OK 74960-4240

Phone

(918) 696-2285

Fax

(918) 696-6746

NPI assigned

Dec 9, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Maryetta School

  • Student Health Clinic/Center
  • Stilwell, OK
  • NPI 1740385657
  NPD (past)

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

{
    "created_epoch": "1733702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1346056975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "470819 E 810 RD",
            "city": "STILWELL",
            "state": "OK",
            "postal_code": "749604240",
            "telephone_number": "918-696-2285",
            "fax_number": "918-696-6746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470819 E 810 RD",
            "city": "STILWELL",
            "state": "OK",
            "postal_code": "749604240",
            "telephone_number": "918-696-2285",
            "fax_number": "918-696-6746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EAGLE",
        "first_name": "ELAN",
        "middle_name": "JOSIAH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-09",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wojciech L. Dulowski, M.D.
• Carney L Duncan
• Christina Lynn Duncan
• Kimberly Jo Duncan
• Shandi Leigh Duncan
• Yolanda Echeverria, BSW
• Echota Behavioral Health Services, LLC
• William Dale Edgmon, REGISTERED NURSE
• Sunday Sue Ellis
• Lyla English

• All providers in Stilwell, OK
• Personal Care Attendant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.