NPIMap

Individual provider Active NPI

Bob Burlison, P.A.-C

  • Physician Assistant
  • Atoka, OK
National Provider Identifier
1710020151
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA642 Issued in OK
Practice address
1590 W Liberty Rd
Atoka, OK 74525-1701
Phone
(580) 889-3333
NPI assigned
Feb 15, 2007
Sex
Male
Sole proprietor
No

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Choctaw Nation of Oklahoma 271 clinicians

Practice addresses (Care Compare)

1201 W Liberty Rd
Choctaw Nation Health Care Atoka
Atoka, OK 74525-1639
Phone (539) 316-6391

Hospital & facility affiliations

  • Choctaw Nation Health Services Authority Hospital, Talihina, OK, CCN 370172

Merit-based Incentive Payment System (MIPS)

Final score
77.07 of 100Reported as group
Quality
73.06
Improvement activities
40
Cost
69.92

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050506000571 OK Practitioner - Physician Assistant 3971550906 Reassigns benefits to 1 organization
I20110324000424 TX Practitioner - Physician Assistant 3971550906 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
642OKMDPsychologist
PA642OKMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cah Acquisition Company 16 LLC CurrentSince May 1, 2014 Accepting new patients
Choctaw Nation of Oklahoma CurrentSince Sep 15, 2020 Accepting new patients
Choctaw Nation of Oklahoma CurrentSince Sep 15, 2020 Accepting new patients
Urgent Care Clinic of Atoka, PC Past Accepting new patients
Neon Clinic Inc Past Accepting new patients

Locations

1585 W Liberty Rd
Atoka, OK 74525
Phone (580) 889-1981

1300 E Martin Luther King Dr
Broken Bow, OK 74728
Phone (580) 208-2204

1600 N Washington Ave
Durant, OK 74701
Phone (580) 740-0205

410 N M St
Hugo, OK 74743
Phone (580) 326-7561

902 E Lincoln Rd
Idabel, OK 74745
Phone (580) 286-2600

1127 S George Nigh Expy
McAlester, OK 74501
Phone (800) 349-7026

109 Kerr Blvd
Poteau, OK 74953
Phone (918) 649-1100

401 NW H St
Stigler, OK 74462
Phone (918) 967-4682

2204 E Main St
Stigler, OK 74462
Phone (918) 967-9200

1 Choctaw Way
Talihina, OK 74571
Phone (918) 423-8440

205 Dallas St
Talihina, OK 74571
Phone (918) 567-3636

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA642 OK Primary

Addresses

NPPES NPI Registry

Primary practice location

1590 W Liberty Rd
Atoka, OK 74525-1701

Mailing address

804 W Enid Ave
Wilburton, OK 74578-2248
Phone (580) 239-0449

Other practice location 1

1 Choctaw Way
Talihina, OK 74571-2022
Phone (918) 567-7000

Other practice location 2

806 Highway 2 N
Wilburton, OK 74578-3625
Phone (918) 465-2391 ext. 235

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 30, 2020.

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1710020151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 W ENID AVE",
            "city": "WILBURTON",
            "state": "OK",
            "postal_code": "745782248",
            "telephone_number": "580-239-0449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1590 W LIBERTY RD",
            "city": "ATOKA",
            "state": "OK",
            "postal_code": "745251701",
            "telephone_number": "580-889-3333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Choctaw Way",
            "address_purpose": "LOCATION",
            "city": "Talihina",
            "state": "OK",
            "postal_code": "745712022",
            "country_code": "US",
            "telephone_number": "918-567-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "806 Highway 2 N",
            "address_purpose": "LOCATION",
            "city": "Wilburton",
            "state": "OK",
            "postal_code": "745783625",
            "country_code": "US",
            "telephone_number": "918-465-2391 x235",
            "fax_number": "918-465-3755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURLISON",
        "first_name": "BOB",
        "name_prefix": "Mr.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "PA642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atoka, OK

Sources for this page

Verify at the official NPI Registry.