Individual provider Active NPI

Charolette Ann Myles-Nixon, PH.D

  • School Psychologist
  • Oklahoma City, OK
National Provider Identifier
1861718702
Registry record updated Apr 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
115677 Issued in OK
Practice address
2231 NW 16TH St
Oklahoma City, OK 73107-4926
Phone
(405) 708-2689
NPI assigned
Apr 16, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X 115677 OK Primary

Addresses

Primary practice location

2231 NW 16TH St
Oklahoma City, OK 73107-4926

Mailing address

PO Box 60004
Oklahoma City, OK 73146-0004
Phone (405) 708-2689

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

LicenseStateTypeSpecialty
115677OKMDSchool Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1271376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271376000000",
    "number": "1861718702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60004",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731460004",
            "telephone_number": "405-708-2689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2231 NW 16TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731074926",
            "telephone_number": "405-708-2689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYLES-NIXON",
        "first_name": "CHAROLETTE",
        "middle_name": "ANN",
        "name_prefix": "Prof.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-16",
        "last_updated": "2010-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "OK",
            "license": "115677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2010; 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.