Individual provider Active NPI

Zachry Deaton, RD/LD

  • Registered Dietitian
  • Purcell, OK
National Provider Identifier
1376918268
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
2114 Issued in OK
Practice address
1438 Hardcastle Blvd
Purcell, OK 73080-8233
Phone
(405) 527-4700
NPI assigned
Dec 3, 2015
Last updated
Jul 10, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 2114 OK Primary

Addresses

Primary practice location

1438 Hardcastle Blvd
Purcell, OK 73080-8233

Mailing address

1921 Stonecipher Dr
Ada, OK 74820-3439
Phone (580) 421-4570

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220831000404 TX Practitioner - Registered Dietitian Or Nutrition Professional 2860776457 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2114OKMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Chickasaw Nation Division of Health Current Accepting new patients
Chickasaw Nation Division of Health CurrentSince Aug 17, 2022 Accepting new patients
Chickasaw Nation Division of Health Chickasaw Nation Medical Center CurrentSince Aug 17, 2022 Accepting new patients

Locations

1921 Stonecipher Dr
Ada, OK 74820
Phone (580) 421-4570

2510 Chickasaw Blvd
Ardmore, OK 73401
Phone (580) 226-8181

1438 Hardcastle Blvd
Purcell, OK 73080
Phone (405) 527-4700

817 E 6th St
Tishomingo, OK 73460
Phone (580) 371-2392

Organizations & group practices 3

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": "1449100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1376918268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1921 STONECIPHER DR",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748203439",
            "telephone_number": "580-421-4570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1438 HARDCASTLE BLVD",
            "city": "PURCELL",
            "state": "OK",
            "postal_code": "730808233",
            "telephone_number": "405-527-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEATON",
        "first_name": "ZACHRY",
        "credential": "RD/LD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-03",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OK",
            "license": "2114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Purcell, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.