Individual provider Active NPI

Bristol C Tottress

  • Counselor
  • Claremore, OK
National Provider Identifier
1992067862
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
12005 E 470 Rd
Claremore, OK 74017-3737
Phone
(918) 342-7816
Fax
(918) 342-0087
NPI assigned
Jun 15, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X OK Primary

Addresses

Primary practice location

12005 E 470 Rd
Claremore, OK 74017-3737

Mailing address

12005 E 470 Rd
Claremore, OK 74017-3737
Phone (918) 342-7816

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240924002854 OK Practitioner - Mental Health Counselor 7214478783 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Laureate Psychiatric Clinic and Hospital Inc CurrentSince Sep 30, 2024 Accepting new patients

Locations

6600 S Yale Ave
Ste 1200
Tulsa, OK 74136
Phone (918) 488-6045

6600 S Yale Ave
Ste 600
Tulsa, OK 74136
Phone (918) 491-5990

6655 S Yale Ave
Tulsa, OK 74136
Phone (918) 481-4000

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.

NPI Registry JSON

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

{
    "created_epoch": "1339718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1992067862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12005 E 470 RD",
            "city": "CLAREMORE",
            "state": "OK",
            "postal_code": "740173737",
            "telephone_number": "918-342-7816",
            "fax_number": "918-342-0087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12005 E 470 RD",
            "city": "CLAREMORE",
            "state": "OK",
            "postal_code": "740173737",
            "telephone_number": "918-342-7816",
            "fax_number": "918-342-0087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOTTRESS",
        "first_name": "BRISTOL",
        "middle_name": "C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-15",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Claremore, OK

Sources for this page

Verify at the official NPI Registry.