Individual provider Active NPI

Alice Faye Eaglin, LPN

  • Private Vehicle
  • Big Cabin, OK
National Provider Identifier
1578760203
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Private VehicleTaxonomy code 347C00000X
Practice address
31850 So 4320 Rd
Big Cabin, OK 74332
Phone
(918) 693-5209
NPI assigned
Jun 27, 2007
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X OK
Private Vehicle 347C00000X OK Primary

Addresses

Primary practice location

31850 So 4320 Rd
Big Cabin, OK 74332

Mailing address

31850 So 4320 Rd
Big Cabin, OK 74332
Phone (918) 693-5209

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
100479240DOKMDIntellectual and/or Developmental Disabilities Residential Treatment Facility
100479240BOKMDPrivate Vehicle

NPI Registry JSON

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1578760203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31850 SO 4320 RD",
            "city": "BIG CABIN",
            "state": "OK",
            "postal_code": "74332",
            "telephone_number": "918-693-5209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31850 SO 4320 RD",
            "city": "BIG CABIN",
            "state": "OK",
            "postal_code": "74332",
            "telephone_number": "918-693-5209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EAGLIN",
        "first_name": "ALICE",
        "middle_name": "FAYE",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-27",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "OK",
            "license": null,
            "primary": false
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Big Cabin, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.