Barry Luke Botone, P.R.S.S

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

100 Red Moon Circle
Concho, OK 73022-7302

Phone

(405) 422-7452

NPI assigned

Apr 5, 2023

Last updated

Apr 5, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

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

{
    "created_epoch": "1680652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1407541618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 RED MOON CIRCLE",
            "city": "CONCHO",
            "state": "OK",
            "postal_code": "73022",
            "telephone_number": "405-422-7452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 RED MOON CIRCLE",
            "city": "CONCHO",
            "state": "OK",
            "postal_code": "730227302",
            "telephone_number": "405-422-7452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTONE",
        "first_name": "BARRY",
        "middle_name": "LUKE",
        "credential": "P.R.S.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-04-05",
        "last_updated": "2023-04-05",
        "certification_date": "2023-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheyenne and Arapaho Tribes of Oklahoma
• Casandra Fay Fraser
• Mackenzie Linn Washa

• Peer Specialist in Concho, OK
• Providers in Concho, OK by specialty
• Peer Specialist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2023; 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.