Old Tyme Home Visits LLC

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

49456 Issued in OK

Legal business name

OLD TYME HOME VISITS LLC

Practice address

128 W Main St
Purcell, OK 73080-4220

Phone

(405) 527-4704

Fax

(405) 527-5976

NPI assigned

Aug 26, 2015

Last updated

Aug 26, 2015By 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

Diane Dewbre, ARNP-CNPNPI 1417131038

Title

Advanced Practice Nurse / Owner

Phone

(405) 527-4704

Specialties & licenses 1

Addresses

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.

• Diane Dewbre, GNP-BC

  • Gerontology Nurse Practitioner
  • Purcell, OK
  • NPI 1417131038
  Authorized official Same address or phone

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

{
    "created_epoch": "1440547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440547200000",
    "number": "1659748556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 W MAIN ST",
            "city": "PURCELL",
            "state": "OK",
            "postal_code": "730804220",
            "telephone_number": "405-527-4704",
            "fax_number": "405-527-5976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 W MAIN ST",
            "city": "PURCELL",
            "state": "OK",
            "postal_code": "730804220",
            "telephone_number": "405-527-4704",
            "fax_number": "405-527-5976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD TYME HOME VISITS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-26",
        "last_updated": "2015-08-26",
        "status": "A",
        "authorized_official_last_name": "DEWBRE",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "ADVANCED PRACTICE NURSE / OWNER",
        "authorized_official_telephone_number": "405-527-4704",
        "authorized_official_credential": "ARNP-CNP"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OK",
            "license": "49456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ronnie Dale Page, O.D.
• Chris Parks, CRNA
• Victor Eduardo Pascual Chagman, MD

• Gerontology Nurse Practitioner in Purcell, OK
• Providers in Purcell, OK by specialty
• Gerontology Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2015; 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.