Bruce Wayne Staeheli, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

35 072661 Issued in OH

Practice address

119 Clubhouse PL
Elk City, OK 73644-7301

Phone

(580) 303-4664

NPI assigned

Mar 12, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in TX, MS2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Carr PLLC

  • Emergency Medicine Physician
  • Brentwood, TN
  • NPI 1548677610

  MS

  Medicare reassignment NPD
• Concord Medical Group of Texas PLLC

  • Emergency Medicine Physician
  • Lubbock, TX
  • NPI 1750790762
  Medicare reassignment NPD
• Concord Medical Group PLLC

  • Emergency Medicine Physician
  • Lubbock, TX
  • NPI 1083630610
  Medicare reassignment NPD
• DHHS PHS Naihs Crownpoint Hospital

  • General Acute Care Hospital
  • Crownpoint, NM
  • NPI 1114960093

  TX

  Medicare reassignment NPD
• Emergency Services of Texas PA

  • Emergency Medicine Physician
  • Orange, TX
  • NPI 1174932131
  Medicare reassignment NPD
• Victoria Emergency Partners LLC

  • Emergency Medicine Physician
  • Gonzales, TX
  • NPI 1164770996
  Medicare reassignment NPD
• Pueblo Pintado Clinic

  • Clinic/Center
  • Cuba, NM
  • NPI 1023051133
  NPD
• Sterling Initiatives

  • Emergency Medicine Physician
  • Hawkinsville, GA
  • NPI 1295581973
  NPD
• Sterling Initiatives

  • Emergency Medicine Physician
  • Dallas, TX
  • NPI 1326452947
  NPD
• Thoreau Clinic

  • Clinic/Center
  • Thoreau, NM
  • NPI 1679516702
  NPD
• 4M Emergency Systems of Parkersburg, Inc

  • Emergency Medicine Physician
  • Parkersburg, WV
  • NPI 1295787349
  NPD (past)
• Memorial Hospital of Geneva

  • Emergency Medicine Physician
  • Geneva, OH
  • NPI 1164519831
  NPD (past)

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221523200000",
    "number": "1508998899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2467",
            "city": "ELK CITY",
            "state": "OK",
            "postal_code": "736482467",
            "telephone_number": "580-303-4664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 CLUBHOUSE PL",
            "city": "ELK CITY",
            "state": "OK",
            "postal_code": "736447301",
            "telephone_number": "580-303-4664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAEHELI",
        "first_name": "BRUCE",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-12",
        "last_updated": "2008-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35 072661",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WV DWC",
            "identifier": "1062641",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000561000",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810012159",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000381808",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2015698",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robin Smith
• Stephen Tyler Smith, D.C.
• Justin W Smoot, DIPL. O.M.
• Mechelle Spikes, APRN, FNP-C
• Billy Charles Spurlock, DC
• Billie Dawn Stamm, RN
• Farrina Steel
• Bruce Daniel Storm Jr., DDS
• Stover Family Chiropractic, PLLC
• Patrick Pete Stover, D.D.S.

• Emergency Medicine Physician in Elk City, OK
• Providers in Elk City, OK by specialty
• Emergency Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2008; 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.