Active NPI
Polly Bredy, M ED LPC
- Professional Counselor
- Hobart, OK
National Provider Identifier
1811270424
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2535
- Practice address
- 901 S Broadway
Hobart, OK 73651-1834 - Phone
- (580) 726-3383
- NPI assigned
- Sep 21, 2011
- Sex
- Female
- Sole proprietor
- No
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 | 2535 | OK | Primary |
Addresses
Primary practice location
901 S Broadway
Hobart, OK 73651-1834
Mailing address
15135 N 2330 Rd
Roosevelt, OK 73564-4023
Phone (580) 331-8727
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100707910B | Medicaid | OK |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2535 | OK | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Great Plains Youth and Family Services | Past | Accepting new patients | |
| Great Plains Youth and Family Services | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Behavioral Health Agency
- Hobart, OK
- NPI 1093897415
-
- Community/Behavioral Health Agency
- Hobart, OK
- NPI 1457507428
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316563200000",
"number": "1811270424",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15135 N 2330 RD",
"city": "ROOSEVELT",
"state": "OK",
"postal_code": "735644023",
"telephone_number": "580-331-8727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 S BROADWAY",
"city": "HOBART",
"state": "OK",
"postal_code": "736511834",
"telephone_number": "580-726-3383"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BREDY",
"first_name": "POLLY",
"name_prefix": "Mrs.",
"credential": "M ED LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-21",
"last_updated": "2011-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OK",
"license": "2535",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100707910B",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hobart, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.