Individual provider Active NPI

Brian Lee Coley, ATC/LAT

  • Student in an Organized Health Care Education/Training Program
  • Tulsa, OK
National Provider Identifier
1780648147
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
AT94 Issued in OK
Practice address
3905 S Hudson Ave
Tulsa, OK 74135-5607
Phone
(918) 627-3390
Fax
(918) 664-2134
NPI assigned
Apr 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X AT94 OK Primary

Addresses

Primary practice location

3905 S Hudson Ave
Tulsa, OK 74135-5607

Mailing address

3905 S Hudson Ave
Tulsa, OK 74135-5607
Phone (918) 627-3390

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

State licenses

LicenseStateTypeSpecialty
AT94OKMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1780648147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3905 S HUDSON AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741355607",
            "telephone_number": "918-627-3390",
            "fax_number": "918-664-2134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3905 S HUDSON AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741355607",
            "telephone_number": "918-627-3390",
            "fax_number": "918-664-2134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEY",
        "first_name": "BRIAN",
        "middle_name": "LEE",
        "credential": "ATC/LAT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-13",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OK",
            "license": "AT94",
            "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 Jul 13, 2026; 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.