Individual provider Active NPI

James R. Yeary, DDS

  • General Practice Dentistry
  • Norman, OK
National Provider Identifier
1386636504
Registry record updated Jan 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4716 Issued in OK
Practice address
801 Wall St
Norman, OK 73069-6303
Phone
(405) 329-7171
Fax
(405) 321-7540
NPI assigned
Aug 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4716 OK Primary

Addresses

Primary practice location

801 Wall St
Norman, OK 73069-6303

Mailing address

801 Wall St
Norman, OK 73069
Phone (405) 329-7171

Other identifiers 1

IdentifierTypeStateIssuer
100112740AMedicaidOK

Other names 1

  • James R Yeary Professional name

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
I20160323000165 OK Order and Referring Only - DentistPractitioner - Dentist 1355648197

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4716OKMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
James R. Yeary P.L.L.C. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231113600000",
    "number": "1386636504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 WALL ST",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "73069",
            "telephone_number": "405-329-7171",
            "fax_number": "405-321-7540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 WALL ST",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730696303",
            "telephone_number": "405-329-7171",
            "fax_number": "405-321-7540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEARY",
        "first_name": "JAMES",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2009-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "4716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100112740A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAMES",
            "last_name": "YEARY",
            "middle_name": "R",
            "credential": "DDS, PC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Norman, OK

Sources for this page

Verify at the official NPI Registry.