Individual provider Active NPI

David Wayne Brewer

  • Peer Specialist
  • Yukon, OK
National Provider Identifier
1710654249
Registry record updated Aug 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Practice address
1501 Commerce Street
Yukon, OK 73099
Phone
(405) 422-8883
NPI assigned
Aug 24, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 175T00000X OK Primary

Addresses

Primary practice location

1501 Commerce Street
Yukon, OK 73099

Mailing address

633 SW 46TH St
Oklahoma City, OK 73109-7307
Phone (405) 476-7400

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": "1629763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1710654249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 SW 46TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731097307",
            "telephone_number": "405-476-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 COMMERCE STREET",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "73099",
            "telephone_number": "405-422-8883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREWER",
        "first_name": "DAVID",
        "middle_name": "WAYNE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-24",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Peer Specialist",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yukon, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.