Ian Dow Bushyhead, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4743 Issued in OK

Practice address

14601 E 88TH PL N Ste 308
Owasso, OK 74055-4966

Phone

(918) 528-4733

Fax

(918) 528-4739

NPI assigned

Jul 1, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ian.bushyhead@214522098548740.direct.elationemr.com

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.

• St John Urgent Care Clinics Inc

  • Urgent Care Clinic/Center
  • Tulsa, OK
  • NPI 1003918830
  Medicare reassignment NPD
• St. John Physicians, Inc.

  • Internal Medicine Physician
  • Tulsa, OK
  • NPI 1336194406

  Family Medicine

  Medicare reassignment NPD
• Warren Clinic Inc

  • General Practice Physician
  • Tulsa, OK
  • NPI 1174582282
  Medicare reassignment NPD
• St. John Physicians, Inc

  • Rural Health Clinic/Center
  • Barnsdall, OK
  • NPI 1033176367
  NPD

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

{
    "created_epoch": "1246406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1679701361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14601 E 88TH PL N STE 308",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740554966",
            "telephone_number": "918-528-4733",
            "fax_number": "918-528-4739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14601 E 88TH PL N STE 308",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740554966",
            "telephone_number": "918-528-4733",
            "fax_number": "918-528-4739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSHYHEAD",
        "first_name": "IAN",
        "middle_name": "DOW",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-01",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "4743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle R. Burger, CPNP
• Jacilyn Burns
• Jasmine Burton
• Amber Nicole Burwell
• Courtney Busby, APRN
• Ashley Dawn Butler, LMT
• Michael Butler
• Rachael L Butler
• Kevin D Bybee, D.D.S.
• Jeremy Bymaster, PHARMD

• Family Medicine Physician in Owasso, OK
• Providers in Owasso, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.