Individual provider Active NPI

Ernest Edward Beckham, PHD

  • Psychologist
  • Oklahoma City, OK
National Provider Identifier
1871561027
Registry record updated Nov 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
317 Issued in OK
Practice address
4601 N Classen Blvd
Oklahoma City, OK 73118-4815
Phone
(405) 840-9999
Fax
(405) 840-9998
NPI assigned
Mar 14, 2006
Last updated
Nov 8, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 317 OK Primary

Addresses

Primary practice location

4601 N Classen Blvd
Oklahoma City, OK 73118-4815

Mailing address

4601 N Classen Blvd
Oklahoma City, OK 73118-4815
Phone (405) 840-9999

Other identifiers 1

IdentifierTypeStateIssuer
100841560AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120424000539 OK Practitioner - Clinical Psychologist 5496917247 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Texas Tech University Health Science Center School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Integrity Behavioral Medicine PLLCGroup PAC ID 7911395082, 3 clinicians

Practice addresses (Care Compare)

2525 NW Expressway
Suite 312
Oklahoma City, OK 73112-7200
Phone (405) 840-9999

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
317OKMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrity Behavioral Medicine, PLLC CurrentSince Nov 1, 2021 Accepting new patients

Locations

2525 NW Expressway
Ste 312
Oklahoma City, OK 73112
Phone (405) 840-9999

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.

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383868800000",
    "number": "1871561027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 N CLASSEN BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731184815",
            "telephone_number": "405-840-9999",
            "fax_number": "405-840-9998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 N CLASSEN BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731184815",
            "telephone_number": "405-840-9999",
            "fax_number": "405-840-9998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKHAM",
        "first_name": "ERNEST",
        "middle_name": "EDWARD",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2013-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OK",
            "license": "317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100841560A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.