Active NPI
Bruce Alan Daniels, MD
- Cardiovascular Disease Physician
- Oklahoma City, OK
National Provider Identifier
1972584050
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 10948
- Practice address
- 4221 S Western Ave
Ste 4045
Oklahoma City, OK 73109-3447 - Phone
- (405) 636-1166
- Fax
- (405) 632-8446
- NPI assigned
- Nov 7, 2005
- 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 |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 10948 | OK | Primary |
Addresses
Primary practice location
4221 S Western Ave
Ste 4045
Oklahoma City, OK 73109-3447
Mailing address
4221 S Western Ave
Ste 4045
Oklahoma City, OK 73109-3447
Phone (405) 636-1166
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100100150A | Medicaid | OK |
Other names 1
- Bruce Alan Daniels
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)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summit Medical Center | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- General Acute Care Hospital
- Edmond, OK
- NPI 1356574560
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600732800000",
"number": "1972584050",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4221 S WESTERN AVE",
"address_2": "STE 4045",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731093447",
"telephone_number": "405-636-1166",
"fax_number": "405-632-8446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4221 S WESTERN AVE",
"address_2": "STE 4045",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731093447",
"telephone_number": "405-636-1166",
"fax_number": "405-632-8446"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DANIELS",
"first_name": "BRUCE",
"middle_name": "ALAN",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-11-07",
"last_updated": "2020-09-22",
"certification_date": "2020-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "OK",
"license": "10948",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100100150A",
"state": "OK"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "BRUCE",
"last_name": "DANIELS",
"middle_name": "ALAN",
"credential": "MD",
"code": "2",
"type": "Professional Name"
}
]
}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 Sep 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.