Fort Cobb-Broxton Sdi-167

Primary specialty

Local Education Agency (LEA)Taxonomy code 251300000X

Legal business name

FORT COBB-BROXTON SDI-167

Practice address

600 Towakonie St
Fort Cobb, OK 73038

Phone

(405) 643-2336

Fax

(405) 643-2547

NPI assigned

Mar 8, 2007

Last updated

Dec 19, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Kyle W Lierle

Title

Superintendent

Phone

(405) 643-2336

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324252800000",
    "number": "1518098722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130",
            "city": "FORT COBB",
            "state": "OK",
            "postal_code": "730380130",
            "telephone_number": "405-643-2336",
            "fax_number": "405-643-2547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 TOWAKONIE ST",
            "city": "FORT COBB",
            "state": "OK",
            "postal_code": "73038",
            "telephone_number": "405-643-2336",
            "fax_number": "405-643-2547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT COBB-BROXTON SDI-167",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2011-12-19",
        "status": "A",
        "authorized_official_last_name": "LIERLE",
        "authorized_official_first_name": "KYLE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "SUPERINTENDENT",
        "authorized_official_telephone_number": "405-643-2336",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100684500A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiffany Rachel Beene, M.S.,CCC-SLP
• Joyce Alene Inselman, ARNP
• Todd Franklin Johnston
• David Schumann, DDS
• Teresa Dawn Sumka
• Variety Care, Inc (Variety Care Fort Cobb)

• Local Education Agency (LEA) in Fort Cobb, OK
• Providers in Fort Cobb, OK by specialty
• Local Education Agency (LEA) in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2011; 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.