Brad Alan Liston, D.O.

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

4659 Issued in OK

Practice address

1908 N 14TH St Ste 204
Ponca City, OK 74601-2039

Phone

(580) 763-5900

Fax

(580) 763-5901

NPI assigned

Jul 9, 2008

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

Electronic endpoints 1

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Integris Ambulatory Care CorporationGroup PAC ID 2365408465, 687 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Angels Care Home Health of East Oklahoma Home health agency, Broken Arrow, OK, CCN 377171
• Homecall Home health agency, Stillwater, OK, CCN 377059
• Elara Caring Xviii Home health agency, Stillwater, OK, CCN 377742
• Integris Health Ponca City Hospital, Ponca City, OK, CCN 370006
• Stillwater Medical Center Hospital, Stillwater, OK, CCN 370049
• O U Medical Center Hospital, Oklahoma City, OK, CCN 370093
• Stillwater Medical-Blackwell Hospital, Blackwell, OK, CCN 370780

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bliston489479@direct.integrisok.com

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.

• Integris Ambulatory Care Corporation

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1750333936
  Medicare reassignment Care Compare group NPD
• Integris Ambulatory Care C Orporation

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1326076027
  NPD (past)
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Five Star Home Health, Inc.

  • Home Health Agency
  • Broken Arrow, OK
  • NPI 1851359194
  Care Compare affiliation
• Homecare Clinicians LLC

  • Home Health Agency
  • Stillwater, OK
  • NPI 1942440102
  Care Compare affiliation
• Integris Health Ponca City Hospital Inc

  • General Acute Care Hospital
  • Ponca City, OK
  • NPI 1548047616
  Care Compare affiliation
• Mays Homecall Home Health of Stillwater, LLC

  • Home Health Agency
  • Stillwater, OK
  • NPI 1730504481
  Care Compare affiliation
• Ou Medicine Inc.

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1649794157
  Care Compare affiliation
• Stillwater Medical Center Authority

  • Rural Acute Care Hospital
  • Blackwell, OK
  • NPI 1104375237
  Care Compare affiliation
• Stillwater Medical Center Authority

  • General Acute Care Hospital
  • Stillwater, OK
  • NPI 1164494027
  Care Compare affiliation

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

{
    "created_epoch": "1215561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1487817375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1908 N 14TH ST STE 204",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746012039",
            "telephone_number": "580-763-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1908 N 14TH ST STE 204",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746012039",
            "telephone_number": "580-763-5900",
            "fax_number": "580-763-5901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISTON",
        "first_name": "BRAD",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-09",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "OK",
            "license": "4659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "liston-brad.liston.2@4696.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "1908 N 14th St Ste 204",
            "city": "Ponca City",
            "state": "OK",
            "country_code": "US",
            "postal_code": "746012039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lincare Inc.
• Anna Cheyenne Lindell
• Brook Michelle Linder, APRN-CNP
• Candy Lee Sconyers Lindsey, D.O.
• Lisa Seabridge, LCSW
• Michael Littlevoice
• Katie Dean Logan, CTRS/L
• Sierra Joy Logsdon
• Donna Longbrake, B.S.
• Scott P Looper

• Adult Medicine Physician in Ponca City, OK
• Providers in Ponca City, OK by specialty
• Adult Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.