Individual provider Active NPI

Tommy Lee Vanderford

  • Behavior Analyst
  • Tulsa, OK
National Provider Identifier
1740614411
Registry record updated Aug 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
1410 S 128TH East Ave
Tulsa, OK 74128-5430
Phone
(918) 955-6921
NPI assigned
Aug 29, 2013
Last updated
Aug 29, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X NU Primary

Addresses

Primary practice location

1410 S 128TH East Ave
Tulsa, OK 74128-5430

Mailing address

1410 S 128TH East Ave
Tulsa, OK 74128-5430
Phone (918) 955-6921

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": "1377734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377734400000",
    "number": "1740614411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 S 128TH EAST AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741285430",
            "telephone_number": "918-955-6921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 S 128TH EAST AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741285430",
            "telephone_number": "918-955-6921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERFORD",
        "first_name": "TOMMY",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-29",
        "last_updated": "2013-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2013; 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.