Active NPI
R Bruce Parker MD PC
- Specialist
- Norman, OK
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 15169
- Legal business name
- R BRUCE PARKER MD PC
- Practice address
- 3441 24TH Ave NW Ste 105
Norman, OK 73069-6716 - Phone
- (405) 321-2929
- Fax
- (405) 366-8701
- NPI assigned
- Mar 13, 2009
- Last updated
- Jun 15, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Russell Bruce Parker, MD
- Title
- Corporation Head
- Phone
- (405) 321-2929
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 15169 | OK | Primary |
Addresses
Primary practice location
3441 24TH Ave NW Ste 105
Norman, OK 73069-6716
Mailing address
3441 24TH Ave NW Ste 105
Norman, OK 73069-6716
Phone (140) 532-1292
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100147560A | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 37D0947968 | R Bruce Parker MD | Certificate of waiver | Jun 28, 2028 |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1236902400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1623715200000",
"number": "1558502013",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3441 24TH AVE NW STE 105",
"city": "NORMAN",
"state": "OK",
"postal_code": "730696716",
"telephone_number": "140-532-1292",
"fax_number": "405-366-8701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3441 24TH AVE NW STE 105",
"city": "NORMAN",
"state": "OK",
"postal_code": "730696716",
"telephone_number": "405-321-2929",
"fax_number": "405-366-8701"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "R BRUCE PARKER MD PC",
"organizational_subpart": "NO",
"enumeration_date": "2009-03-13",
"last_updated": "2021-06-15",
"certification_date": "2021-06-15",
"status": "A",
"authorized_official_last_name": "PARKER",
"authorized_official_first_name": "RUSSELL",
"authorized_official_middle_name": "BRUCE",
"authorized_official_title_or_position": "CORPORATION HEAD",
"authorized_official_telephone_number": "405-321-2929",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist",
"state": "OK",
"license": "15169",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100147560A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Norman, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.