Individual provider Active NPI

Todd Bradford Pelton, PAC

  • Physician Assistant
  • Norman, OK
National Provider Identifier
1770560567
Registry record updated Mar 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA968 Issued in OK
Practice address
15951 Little Axe Dr
Norman, OK 73026-9088
Phone
(405) 447-0300
Fax
(405) 701-7914
NPI assigned
Dec 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA968 OK Primary

Addresses

Primary practice location

15951 Little Axe Dr
Norman, OK 73026-9088

Mailing address

15951 Little Axe Dr
Norman, OK 73026-9088
Phone (405) 447-0300

Other identifiers 1

IdentifierTypeStateIssuer
200161660AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081010000314 OK Practitioner - Physician Assistant 6103820022 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Absentee Shawnee Tribal Health Authority, IncGroup PAC ID 5799171088, 83 clinicians

Practice addresses (Care Compare)

15951 Little Axe Dr
Norman, OK 73026-9088
Phone (405) 447-0300

Hospital & facility affiliations

  • Completecare Home Health, LLC Home health agency, Norman, OK, CCN 377286

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
968OKMDAddiction (Substance Use Disorder) Counselor

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774396800000",
    "number": "1770560567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15951 LITTLE AXE DR",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730269088",
            "telephone_number": "405-447-0300",
            "fax_number": "405-701-7914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15951 LITTLE AXE DR",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730269088",
            "telephone_number": "405-447-0300",
            "fax_number": "405-701-7914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELTON",
        "first_name": "TODD",
        "middle_name": "BRADFORD",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2026-03-25",
        "certification_date": "2026-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "PA968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200161660A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norman, OK

Sources for this page

Verify at the official NPI Registry.