Active NPI
Joseph Randall Waldron, A.T.C.
- Community Health Worker
- Norman, OK
National Provider Identifier
1679960041
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- 163
- Practice address
- 3400 W Tecumseh Rd
Ste 101
Norman, OK 73072-1810 - Phone
- (405) 360-6764
- Fax
- (405) 360-6769
- NPI assigned
- Apr 22, 2015
- 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 |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | 163 | OK | Primary |
Addresses
Primary practice location
3400 W Tecumseh Rd
Ste 101
Norman, OK 73072-1810
Mailing address
3400 W Tecumseh Rd
Ste 101
Norman, OK 73072-1810
Phone (405) 360-6764
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
| License | State | Type | Specialty |
|---|---|---|---|
| 163 | OK | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1429660800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1429660800000",
"number": "1679960041",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3400 W TECUMSEH RD",
"address_2": "STE 101",
"city": "NORMAN",
"state": "OK",
"postal_code": "730721810",
"telephone_number": "405-360-6764",
"fax_number": "405-360-6769"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3400 W TECUMSEH RD",
"address_2": "STE 101",
"city": "NORMAN",
"state": "OK",
"postal_code": "730721810",
"telephone_number": "405-360-6764",
"fax_number": "405-360-6769"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALDRON",
"first_name": "JOSEPH",
"middle_name": "RANDALL",
"name_prefix": "Mr.",
"credential": "A.T.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-04-22",
"last_updated": "2015-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "OK",
"license": "163",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norman, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.