Active NPI
Brad Epperson
- Professional Counselor
- Stillwater, OK
National Provider Identifier
1790886505
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 4129
- Practice address
- 2224 W 12TH St.
Stillwater, OK 74076-2647 - Phone
- (405) 377-3380
- NPI assigned
- Sep 26, 2006
- Last updated
- Mar 21, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 4129 | OK | Primary |
Addresses
Primary practice location
2224 W 12TH St.
Stillwater, OK 74076-2647
Mailing address
506 Boulder St
Pawnee, OK 74058
Phone (918) 762-2457
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 30, 2024 through Apr 30, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Payne County Youth Services, 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Behavioral Health Agency
- Stillwater, OK
- NPI 1285780734
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1332288000000",
"number": "1790886505",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "506 BOULDER ST",
"city": "PAWNEE",
"state": "OK",
"postal_code": "74058",
"telephone_number": "918-762-2457"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2224 W 12TH ST.",
"city": "STILLWATER",
"state": "OK",
"postal_code": "740762647",
"telephone_number": "405-377-3380"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EPPERSON",
"first_name": "BRAD",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-26",
"last_updated": "2012-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OK",
"license": "4129",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stillwater, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.