Derrick Adrian Braddick

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

2725 E Skelly Dr
Tulsa, OK 74105-6241

Phone

(918) 407-8847

NPI assigned

Aug 10, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Brad Braddick Other name

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

Specialty

Mental Health Counselor

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Omni Medical Group IncGroup PAC ID 9739080490, 82 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Omni Medical Group Inc

  • Internal Medicine Physician
  • Tulsa, OK
  • NPI 1174578249
  Medicare reassignment Care Compare group NPD
• Jeffrey K McIlroy MD Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Claremore, OK
  • NPI 1053531830
  Medicare reassignment NPD

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

{
    "created_epoch": "1218326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218326400000",
    "number": "1942456959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8086 S YALE AVE",
            "address_2": "#236",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741369003",
            "telephone_number": "918-407-6426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2725 E SKELLY DR",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741056241",
            "telephone_number": "918-407-8847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADDICK",
        "first_name": "DERRICK",
        "middle_name": "ADRIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-10",
        "last_updated": "2008-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRAD",
            "last_name": "BRADDICK",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Donna Bracciale, DO
• Jordan Bracht
• Travis John Brachtenbach, DO
• Tamara Deann Brackett-Bryant, B.A. CASE MANAGER
• Ranelle Monterry Bracy-Lewis, D.O.
• Premadonna Braddick, MA, LPC
• Braden Partners LP
• Carla M Bradford, MS
• Mary L Bradford, LCSW
• Summer Dawn Bradford

• Counselor in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.