Breana Elissa Smith, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

6765 Issued in OK

Practice address

4444 E 41St St
Tulsa, OK 74135-2527

Phone

(918) 619-4400

Fax

(918) 619-4334

NPI assigned

Apr 9, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: breana.smith.p1@direct.smc.nextgenshare.com

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.

• Stillwater Medical Center Authority

  • Family Medicine Physician
  • Stillwater, OK
  • NPI 1558377135
  Medicare reassignment NPD
• Stillwater Medical Center Authority

  • Family Medicine Physician
  • Perry, OK
  • NPI 1407729361
  NPD
• Stillwater Medical Center Authority

  • General Acute Care Hospital
  • Stillwater, OK
  • NPI 1164494027
  NPD (past)
• Stillwater Medical Center Physicians

  • Anesthesiology Physician
  • Stillwater, OK
  • NPI 1295859387
  NPD (past)

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

{
    "created_epoch": "1523232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1790282598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4502 E 41ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4444 E 41ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352527",
            "telephone_number": "918-619-4400",
            "fax_number": "918-619-4334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BREANA",
        "middle_name": "ELISSA",
        "name_prefix": "Mrs.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-09",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OK",
            "license": "6765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barret Smith, PHARM. D.
• Blake Lenihan Smith, DMD
• Brandee Nicole Smith
• Brandi J Smith, LCSW
• Brandon Smith
• Brenda Lee Smith, LPC
• Brenda Renee Smith
• Brianne Smith, PA
• Brice Lance Smith, D.D.S.
• Bridget Latrice Smith

• Pediatrics Physician in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Pediatrics Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.