Individual provider Active NPI

Raymond C Hurlbutt, DPM

  • Foot & Ankle Surgery Podiatrist
  • Broken Arrow, OK
National Provider Identifier
1578677662
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
143 Issued in OK
Practice address
421 W Washington St
Broken Arrow, OK 74012-6450
Phone
(918) 455-2001
Fax
(918) 455-6330
NPI assigned
Aug 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 143 OK Primary

Addresses

Primary practice location

421 W Washington St
Broken Arrow, OK 74012-6450

Mailing address

5711 E 71St St
Suite 220
Tulsa, OK 74136-6628
Phone (918) 477-7096

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
143OKMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Tulsa Foot & Ankle Specialist PLLC Foot & Ankle Surgery Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1578677662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5711 E 71ST ST",
            "address_2": "SUITE 220",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741366628",
            "telephone_number": "918-477-7096",
            "fax_number": "918-477-9362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 W WASHINGTON ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740126450",
            "telephone_number": "918-455-2001",
            "fax_number": "918-455-6330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURLBUTT",
        "first_name": "RAYMOND",
        "middle_name": "C",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OK",
            "license": "143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broken Arrow, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.