Individual provider Active NPI

Enola Gay Crayton, L.P.N.

  • Licensed Practical Nurse
  • Clinton, OK
National Provider Identifier
1407094527
Registry record updated Jan 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
0020585 Issued in OK
Practice address
707 S 28TH St
Clinton, OK 73601-4903
Phone
(580) 309-0943
NPI assigned
Jan 27, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 0020585 OK Primary

Addresses

Primary practice location

707 S 28TH St
Clinton, OK 73601-4903

Mailing address

707 S 28TH St
Clinton, OK 73601-4903
Phone (580) 309-0943

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0020585OKMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1233014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233014400000",
    "number": "1407094527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 S 28TH ST",
            "city": "CLINTON",
            "state": "OK",
            "postal_code": "736014903",
            "telephone_number": "580-309-0943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 S 28TH ST",
            "city": "CLINTON",
            "state": "OK",
            "postal_code": "736014903",
            "telephone_number": "580-309-0943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAYTON",
        "first_name": "ENOLA",
        "middle_name": "GAY",
        "credential": "L.P.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-27",
        "last_updated": "2009-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OK",
            "license": "0020585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2009; 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.