Active NPI
Kelli Brumley
- Counselor
- Idabel, OK
National Provider Identifier
1679711196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 411 S Central Ave
Idabel, OK 74745-6059 - Phone
- (580) 286-5045
- NPI assigned
- Jan 22, 2009
- Last updated
- Jun 5, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Psychologist | 103TR0400X | |||
| Case Manager/Care Coordinator | 171M00000X | |||
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
411 S Central Ave
Idabel, OK 74745-6059
Mailing address
PO Box 1030
Antlers, OK 74523-1030
Phone (580) 298-2830
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1232582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1338854400000",
"number": "1679711196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1030",
"city": "ANTLERS",
"state": "OK",
"postal_code": "745231030",
"telephone_number": "580-298-2830"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "411 S CENTRAL AVE",
"city": "IDABEL",
"state": "OK",
"postal_code": "747456059",
"telephone_number": "580-286-5045"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUMLEY",
"first_name": "KELLI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-01-22",
"last_updated": "2012-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "103TR0400X",
"taxonomy_group": "",
"desc": "Psychologist, Rehabilitation",
"state": null,
"license": null,
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Idabel, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.