BLUE BAYOU INC (NPI# 1043568538) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043568538 |
| Entity Type | Organization |
| Organization Name | BLUE BAYOU INC |
| Practice Address |
100 Park Ave Oklahoma City OK 73102-8006 |
| Practice Telephone | 4052293410 |
| Mailing Telephone | 4052293410 |
| Enumeration Date | 2012-08-15 |
| Last Update Date | 2012-09-18 |
| Authorized Official Name | JAMES BRONSON (CEO) |
| Authorized Official Telephone | 4052293410 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0000X |
Family Medicine Specialization: Adolescent Medicine |
12345 | OK | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851649321 | Blue Bayou Inc | Family Medicine | 2100 Southbridge Pkwy, Birmingham, AL 35209-1302 | 2012-08-15 |
| Street Address |
100 PARK AVE |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73102-8006 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548895931 | Court Assistance Programs Inc. | Counselor | 600 N Dewey Avenue Suite 100, Oklahoma City, OK 73102 | 2020-03-06 |
| 1013434117 | Mark Jeffrey Allison I | Case Manager/Care Coordinator | 400 North Walker Avenue, Suite 190, Oklahoma City, OK 73102 | 2017-08-29 |
| 1770009052 | Christopher Minh Nguyen | Clinical Neuropsychologist | 601 Robert S Kerr Ave Apt 108, Oklahoma City, OK 73102 | 2017-08-17 |
| 1700263928 | Micaela Lupov | Physician Assistant | 101 N Robinson Ave Ste 200, Oklahoma City, OK 73102 | 2015-04-27 |
| 1639577885 | La Fuente Prosthetics | Prosthetic/Orthotic Supplier | 229 N.w. 9th Street, Oklahoma City, OK 73102 | 2014-12-19 |
| 1518378603 | Whitney Thorne | Surgery | 608 Nw 9th St Ste 2200, Oklahoma City, OK 73102 | 2014-05-12 |
| 1356680078 | Dustin W Choate | Counselor | 101 Park Ave Ste 1300, Oklahoma City, OK 73102 | 2013-02-01 |
| 1174889778 | Sailesh Arulkumar | Anesthesiology | 535 Nw 9th St Ste 305, Oklahoma City, OK 73102 | 2012-04-09 |
| 1790092328 | Stephanie Brill | Counselor | 415 Nw 5th Street, Oklahoma City, OK 73102 | 2010-09-02 |
| 1205157120 | Mohammad Omar Ramadan | Urology | Ssm Health Medical Group Urology, 608 Nw 9th St., Suite 5000, Oklahoma City, OK 73102 | 2010-06-15 |
| Find all providers in zip 73102 | ||||
| Taxonomy Code | 207QA0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Adolescent Medicine |
| A family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their health care problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508464363 | Karen Elaine Howard | Family Medicine | 3410 State Highway 79, Waurika, OK 73573-5061 | 2020-10-14 |
| 1780634816 | Jerry David Whatley | Family Medicine | 509 Grand Ave, Ardmore, OK 73401-4338 | 2006-05-11 |
| 1972628352 | Ahs Oklahoma Physician Group, LLC | Family Medicine | 562 S Elliott St, Pryor, OK 74361-6411 | 2007-03-21 |
| 1285603720 | Darren Thomas | Family Medicine | 6161 S Yale Ave, Tulsa, OK 74136 | 2006-03-16 |
| City | OKLAHOMA CITY |
| Zip Code | 73102 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.