NPIMap

Individual provider Active NPI

Russell Kyle Brown, DO

  • Internal Medicine Physician
  • Henryetta, OK
National Provider Identifier
1770003063
Registry record updated Sep 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
6371 Issued in OK
Practice address
2403 W Main St
Henryetta, OK 74437-3893
Phone
(918) 526-4463
NPI assigned
Jun 27, 2017
Last updated
Sep 14, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 6371 OK Primary

Addresses

Primary practice location

2403 W Main St
Henryetta, OK 74437-3893

Mailing address

1145 S Utica Ave Ste 110
Tulsa, OK 74104-4013
Phone (918) 579-3825

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
I20200625000830 OK Practitioner - Hospitalist 1557783206 Reassigns benefits to 4 organizations
I20220111000532 TX Practitioner - Emergency Medicine 1557783206 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Oklahoma State University College of Osteopathic Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tulsa Hospital Medicine Physicians Group, LLCGroup PAC ID 7214327832, 132 clinicians

Practice addresses (Care Compare)

2401 W Main St
Hillcrest Hospital Henryetta
Henryetta, OK 74437-3893
Phone (918) 650-1100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Tulsa Hospital Medicine Physicians Group, LLC Internal Medicine CurrentSince Dec 1, 2021 Accepting new patients
Creek Nation Hospital & Clinics Internal Medicine Current Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Jan 1, 2022 Accepting new patients
Oklahoma Infectious Disease Specialists, LLC CurrentSince Nov 1, 2025 Accepting new patients
Ahs Henryetta Hospital LLC CurrentSince Jul 1, 2020 Accepting new patients
Ahs Henryetta Hospital LLC CurrentSince Jul 1, 2020 Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Dec 8, 2020 Accepting new patients
Ahs Cushing Hospital LLC Past Accepting new patients

Locations

2401 W Main St
Henryetta, OK 74437
Phone (918) 650-1100

2403 W Main St
Henryetta, OK 74437
Phone (918) 652-6950

900 E Airport Rd
Okmulgee, OK 74447
Phone 91875643334448

10502 N 110th East Ave
Owasso, OK 74055
Phone (918) 376-8000

10109 E 79th St
Tulsa, OK 74133
Phone (888) 552-6760

1120 S Utica Ave
Tulsa, OK 74104
Phone (918) 579-6090

1145 S Utica Ave
Ste 110
Tulsa, OK 74104
Phone (918) 579-3825

Dept 1038
Tulsa, OK 74182

Dept 1467
Tulsa, OK 74182

Interoperability endpoints

  • Direct secure messaging: rbrown273277@ahs.direct-ci.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1498521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1770003063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 S UTICA AVE STE 110",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044013",
            "telephone_number": "918-579-3825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2403 W MAIN ST",
            "city": "HENRYETTA",
            "state": "OK",
            "postal_code": "744373893",
            "telephone_number": "918-526-4463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "RUSSELL",
        "middle_name": "KYLE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-27",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "6371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henryetta, OK

Sources for this page

Verify at the official NPI Registry.