Carra Lea Burrage

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

1410 South Gin Road
Atoka, OK 74525

Phone

(580) 889-3399

NPI assigned

Sep 18, 2012

Last updated

Sep 18, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Crossroads 1010 LLC

  • Community/Behavioral Health Agency
  • Antlers, OK
  • NPI 1174072482
  Medicare reassignment NPD

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

{
    "created_epoch": "1347926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347926400000",
    "number": "1427308451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 NE 2ND ST",
            "city": "ANTLERS",
            "state": "OK",
            "postal_code": "745232640",
            "telephone_number": "580-271-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 SOUTH GIN ROAD",
            "city": "ATOKA",
            "state": "OK",
            "postal_code": "74525",
            "telephone_number": "580-889-3399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURRAGE",
        "first_name": "CARRA",
        "middle_name": "LEA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-18",
        "last_updated": "2012-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200287120A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Brown, PTA, CSCS
• Kyla Michelle Brown, RD, CNSC
• Codi Burleson
• Bob Burlison, P.A.-C
• Brett Burns, BHRS
• Ryan Butler, PHARMD
• Brenda Butterfield
• Tamara Camp
• Katrina Idell Campbell
• Carl Albert Community Mental Health Center

• Counselor in Atoka, OK
• Providers in Atoka, OK by specialty
• Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.