Active NPI
Brian John Bigelow, PH.D., ABPP
- Clinical Child & Adolescent Psychologist
- Lawton, OK
National Provider Identifier
1780957779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- 995
- Practice address
- 813 SW B Ave
Lawton, OK 73501-3954 - Phone
- (580) 482-3900
- Fax
- (580) 248-1987
- NPI assigned
- Feb 22, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 995 | OK | |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 995 | ZZ | Primary |
Addresses
Primary practice location
813 SW B Ave
Lawton, OK 73501-3954
Mailing address
Box 458 20 Rideau Ave.
Coniston, ONTARIO P0M1M0
CA
Phone (705) 694-5719
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 995 | OK | MD | Professional Counselor |
| 995 | ZZ | MD | Clinical Child & Adolescent Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oklahoma Psychiatric Family Clinic, Inc | Past | Accepting new patients |
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.
-
- Medical Specialty Clinic/Center
- Altus, OK
- NPI 1245794411
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329868800000",
"number": "1780957779",
"addresses": [
{
"country_code": "CA",
"country_name": "Canada",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "BOX 458 20 RIDEAU AVE.",
"city": "CONISTON",
"state": "ONTARIO",
"postal_code": "P0M1M0",
"telephone_number": "705-694-5719"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "813 SW B AVE",
"city": "LAWTON",
"state": "OK",
"postal_code": "735013954",
"telephone_number": "580-482-3900",
"fax_number": "580-248-1987"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BIGELOW",
"first_name": "BRIAN",
"middle_name": "JOHN",
"name_prefix": "Dr.",
"credential": "PH.D., ABPP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-02-22",
"last_updated": "2012-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OK",
"license": "995",
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "ZZ",
"license": "995",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawton, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.