Individual provider Active NPI

Bradley Roscoe Littleton, APRN

  • Family Nurse Practitioner
  • Fort Gibson, OK
National Provider Identifier
1912597204
Registry record updated May 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
200273 Issued in OK
Practice address
108 Lone Oak Cir
Fort Gibson, OK 74434-5001
Phone
(918) 478-6005
Fax
(918) 478-6020
NPI assigned
Jan 21, 2021
Last updated
May 21, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 200273 OK Primary

Addresses

Primary practice location

108 Lone Oak Cir
Fort Gibson, OK 74434-5001

Mailing address

6600 S Yale Ave Ste 1200
Tulsa, OK 74136-3361
Phone (918) 488-6687

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210201001609 OK Practitioner - Nurse Practitioner 9931513009 Reassigns benefits to 1 organization
I20220614002302 TX Practitioner - Nurse Practitioner 9931513009 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
200273OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Creek Nation Hospital & Clinics CurrentSince Mar 11, 2022 Accepting new patients
Creek Nation Hospital & Clinics Current Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Mar 11, 2022 Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Mar 11, 2022 Accepting new patients

Locations

1401 Morris Dr
Okmulgee, OK 74447
Phone (918) 456-0641

900 E Airport Rd
Okmulgee, OK 74447
Phone 91875643334448

1125 E Cleveland Ave
Sapulpa, OK 74066
Phone (918) 224-9310

10109 E 79th St
Tulsa, OK 74133
Phone (888) 552-6760

Dept 1038
Tulsa, OK 74182

Dept 1467
Tulsa, OK 74182

Organizations & group practices 4

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": "1611187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621555200000",
    "number": "1912597204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 S YALE AVE STE 1200",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363361",
            "telephone_number": "918-488-6687",
            "fax_number": "918-488-6098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 LONE OAK CIR",
            "city": "FORT GIBSON",
            "state": "OK",
            "postal_code": "744345001",
            "telephone_number": "918-478-6005",
            "fax_number": "918-478-6020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITTLETON",
        "first_name": "BRADLEY",
        "middle_name": "ROSCOE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-21",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "200273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Gibson, OK

Sources for this page

Verify at the official NPI Registry.