Active NPI
Colton Douglas Dunlap, RDN
- Registered Dietitian
- Glenpool, OK
National Provider Identifier
1659910412
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 2457
- Practice address
- 1306 E 134TH PL
Glenpool, OK 74033-2244 - Phone
- (918) 260-1081
- NPI assigned
- Dec 27, 2019
- Last updated
- Dec 30, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 2457 | OK | Primary |
Addresses
Primary practice location
1306 E 134TH PL
Glenpool, OK 74033-2244
Mailing address
1306 E 134TH PL
Glenpool, OK 74033-2244
Phone (918) 260-1081
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK, TX
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 2017
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1101 S Belmont Ave
Suite 204
Okmulgee, OK 74447-6315
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2457 | OK | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mobile Medical Consultants, PLLC | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Creek Nation Health System
- Clinic/Center
- Muskogee, OK
- NPI 1366593923
-
dba Creek Nation Community Hospital
- Family Medicine Physician
- Okemah, OK
- NPI 1467053173
TX
-
dba Itinerant Primary Care
- General Practice Physician
- Dallas, TX
- NPI 1346839859
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1577404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1577664000000",
"number": "1659910412",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1306 E 134TH PL",
"city": "GLENPOOL",
"state": "OK",
"postal_code": "740332244",
"telephone_number": "918-260-1081"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1306 E 134TH PL",
"city": "GLENPOOL",
"state": "OK",
"postal_code": "740332244",
"telephone_number": "918-260-1081"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUNLAP",
"first_name": "COLTON",
"middle_name": "DOUGLAS",
"credential": "RDN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-12-27",
"last_updated": "2019-12-30",
"certification_date": "2019-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OK",
"license": "2457",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glenpool, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2019; 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.