Active NPI
Nichols Bradley Alberty, LICENSED ORTHOTIST
- Orthotist
- Tahlequah, OK
National Provider Identifier
1891225686
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthotist
- License
- 62
- Practice address
- 1294 East Downing
Suite 3
Tahlequah, OK 74464 - Phone
- (918) 431-1945
- Fax
- (918) 431-1974
- NPI assigned
- Jun 14, 2017
- 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 |
|---|---|---|---|---|
| Orthotist | 222Z00000X | 62 | OK | Primary |
Addresses
Primary practice location
1294 East Downing
Suite 3
Tahlequah, OK 74464
Mailing address
1294 E Downing St Ste 3
Tahlequah, OK 74464-3363
Phone (918) 431-1945
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 |
|---|---|---|---|
| 62 | OK | MD | Advanced Practice Midwife |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hanger Prosthetics & Orthotics East Inc | Orthotist | Past | Accepting new patients |
| Hanger Prosthetics & Orthotics East Inc | Orthotist | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Hanger Clinic
- Prosthetic/Orthotic Supplier
- Tahlequah, OK
- NPI 1174697031
Orthotist
-
dba Hanger Clinic
- Prosthetic/Orthotic Supplier
- Jersey City, NJ
- NPI 1205624301
Orthotist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1891225686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1294 E DOWNING ST STE 3",
"city": "TAHLEQUAH",
"state": "OK",
"postal_code": "744643363",
"telephone_number": "918-431-1945",
"fax_number": "918-431-1974"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1294 EAST DOWNING",
"address_2": "SUITE 3",
"city": "TAHLEQUAH",
"state": "OK",
"postal_code": "74464",
"telephone_number": "918-431-1945",
"fax_number": "918-431-1974"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALBERTY",
"first_name": "NICHOLS",
"middle_name": "BRADLEY",
"credential": "LICENSED ORTHOTIST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-06-14",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "222Z00000X",
"taxonomy_group": "",
"desc": "Orthotist",
"state": "OK",
"license": "62",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tahlequah, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.