Individual provider Active NPI

Lizber Bryan

  • Nurse Practitioner
  • Yukon, OK
National Provider Identifier
1982357976
Registry record updated Jan 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R0063242 Issued in OK
Practice address
1501 W Commerce
Yukon, OK 73099
Phone
(405) 424-7711
NPI assigned
Jan 31, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R0063242 OK Primary

Addresses

Primary practice location

1501 W Commerce
Yukon, OK 73099

Mailing address

2204 Gray Dove Dr
Shawnee, OK 74804-2359
Phone (405) 664-2608

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220527002007 OK Practitioner - Nurse Practitioner 8527446871 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Oklahoma Mental Health CouncilGroup PAC ID 3173514387, 69 clinicians

Practice addresses (Care Compare)

4130 N Lincoln Blvd
Red Rock Behavioral Health Services
Oklahoma City, OK 73105-5209
Phone (405) 424-7711

4400 N Lincoln Blvd
Oklahoma City, OK 73105-5104

4420 N Lincon Blvd
Red Rock Behavioral
Oklahoma City, OK 73105-5104
Phone (405) 424-7711

Merit-based Incentive Payment System (MIPS)

Final score
72.37 of 100Reported as group
Quality
54.6
Improvement activities
40
Cost
74.45

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R0063242OKMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oklahoma Mental Health Council CurrentSince Mar 20, 2022 Accepting new patients
Oklahoma Mental Health Council CurrentSince Mar 20, 2022 Accepting new patients

Locations

4400 N Lincoln Blvd
Oklahoma City, OK 73105

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1643587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643587200000",
    "number": "1982357976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2204 GRAY DOVE DR",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748042359",
            "telephone_number": "405-664-2608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 W COMMERCE",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "73099",
            "telephone_number": "405-424-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYAN",
        "first_name": "LIZBER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-31",
        "last_updated": "2022-01-31",
        "certification_date": "2022-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OK",
            "license": "R0063242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yukon, OK

Sources for this page

Verify at the official NPI Registry.