NPIMap

Organization Active NPI

Bryant Street Family Medicine, P.C.

  • Primary Care Clinic/Center
  • Edmond, OK
National Provider Identifier
1396909446
Registry record updated Nov 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
BRYANT STREET FAMILY MEDICINE, P.C.
Practice address
305 South Bryant Ave
110
Edmond, OK 73034
Phone
(405) 513-7333
Fax
(405) 513-7337
NPI assigned
Jul 17, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2016

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

Authorized official

Name
Dr. Chesca Nicole Craig-Goodell, D.O.NPI 1366510802
Title
Physician
Phone
(405) 513-7333

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X OK Primary

Addresses

Primary practice location

305 South Bryant Ave
110
Edmond, OK 73034

Mailing address

305 South Bryant Ave
110
Edmond, OK 73034
Phone (405) 513-7333

Other identifiers 1

IdentifierTypeStateIssuer
1366510802OtherOKINDIVIDUAL PROVIDER NPI NUMBER

National Provider Directory

National Provider Directory

Locations

13310 N Eastern Ave
Oklahoma City, OK 73131
Phone (405) 513-7333

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1216252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477958400000",
    "number": "1396909446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 SOUTH BRYANT AVE",
            "address_2": "110",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "73034",
            "telephone_number": "405-513-7333",
            "fax_number": "405-513-7337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 SOUTH BRYANT AVE",
            "address_2": "110",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "73034",
            "telephone_number": "405-513-7333",
            "fax_number": "405-513-7337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRYANT STREET FAMILY MEDICINE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-17",
        "last_updated": "2016-11-01",
        "status": "A",
        "authorized_official_last_name": "CRAIG-GOODELL",
        "authorized_official_first_name": "CHESCA",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "405-513-7333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL PROVIDER NPI NUMBER",
            "identifier": "1366510802",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2016; 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.