BRYAN MARSHALL TISON (NPI# 1922518232) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922518232 |
| Entity Type | Individual |
| Full Name | BRYAN MARSHALL TISON |
| Credential | PNP-PC |
| Practice Address |
2000 E 15th St Ste 400a Edmond OK 73013-6673 |
| Practice Telephone | (405) 341-1697 |
| Practice Fax Number | 4053412672 |
| Mailing Telephone | 4053411697 |
| Mailing Fax Number | 4053412672 |
| Enumeration Date | 2017-10-02 |
| Last Update Date | 2017-10-02 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
101670 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2000 E 15TH ST STE 400A |
| City | EDMOND |
| State | OK |
| Zip Code | 73013-6673 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700424900 | Louis Guerrant | Student in an Organized Health Care Education/Training Program | 2000 E 15th St Ste 400a, Edmond, OK 73013-6673 | 2019-12-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407461866 | Alison Church-pugh | Case Manager/Care Coordinator | 1441 Kelley Pointe Pkwy, Edmond, OK 73013 | 2020-09-12 |
| 1699395343 | Dental Specialists of Edmond | Dentist | 16430 Muirfield Pl, Edmond, OK 73013 | 2020-04-23 |
| 1104477215 | Kammerer Richey LLC | Nurse Practitioner | 902 Nw 139th Street Parway, Edmond, OK 73013 | 2019-09-20 |
| 1811459191 | Peak Movement Centre, Pllc | Clinic/Center | 13816 Santa Fe Crossing Dr, Edmond, OK 73013 | 2019-04-04 |
| 1851858492 | Luma Hilal | Pharmacist | 2228 Nw 15th Terrace, Edmond, OK 73013 | 2019-03-01 |
| 1578031571 | Oklahoma Wellness Group LLC | Internal Medicine | 14101 North Esatern Avenue Suite B, Edmond, OK 73013 | 2018-11-07 |
| 1477034395 | Specialty Care Pediatrics, Inc. | Home Health | 2256 Nw 164th Street, Edmond, OK 73013 | 2018-08-28 |
| 1972083921 | Pooja Bhakta | Physician Assistant | Stanbro Healthcare Group LLC, 2000 E. 15th St., Suite 400-a, Edmond, OK 73013 | 2018-08-20 |
| 1417460577 | Oklahoma Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 15103 N Macarthur Blvd, Oklahoma City, OK 73013 | 2017-11-13 |
| 1356879753 | Shawn Smith Optimal Pt and Performance, Pllc | Physical Therapist | 336 Ne 145th Pl, Edmond, OK 73013 | 2017-05-30 |
| Find all providers in zip 73013 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013947928 | Karyl S. Knopps | Nurse Practitioner | 2820 N Kelly Ave, Ste 200, Edmond, OK 73003-3008 | 2006-07-04 |
| 1235480260 | Jennifer J Fulmer | Nurse Practitioner | 523 S Santa Fe Ave, Suite B, Edmond, OK 73003-6226 | 2012-10-01 |
| 1255631388 | Ashley Hebert | Nurse Practitioner | 523 S Santa Fe Ave, Suite B, Edmond, OK 73003-6226 | 2010-10-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396383378 | Lindsey Lauren Givens | Nurse Practitioner | 17513 Aragon Ln, Oklahoma City, OK 73170-9209 | 2019-12-20 |
| 1801453493 | Anna Pauline Reed | Nurse Practitioner | 110 Nw 31st St, Suite 201, Lawton, OK 73505-6100 | 2019-05-20 |
| 1639631781 | April Keith | Nurse Practitioner | 11204 Katie Beth Cir, Oklahoma City, OK 73170-8403 | 2019-04-05 |
| 1861950735 | Michelle Kathleen Spehr | Nurse Practitioner | 3231 Healthplex Dr., Norman, OK 73072 | 2019-03-08 |
| 1740756840 | Darshi Wickrama Edirisooriya | Nurse Practitioner | 1001 N Florence Ave, Claremore, OK 74017-6207 | 2018-10-17 |
| 1326566001 | Minor Pediatrics Kristie Minor Aprn-cnp Pllc | Nurse Practitioner | 29334 N 3950 Rd, Ochelata, OK 74051-2485 | 2017-09-01 |
| 1235667833 | Bobbie Renee Stamps | Nurse Practitioner | 18216 S 410 Rd, Hulbert, OK 74441-1832 | 2017-05-25 |
| 1467984781 | Lauryn Kathleen Trepp | Nurse Practitioner | 2800 W 91st St, Tulsa, OK 74132-3510 | 2017-03-28 |
| 1760922678 | Carissa Declerck | Nurse Practitioner | 1200 Childrens Ave Ste 2f, Oklahoma City, OK 73104-4637 | 2017-02-27 |
| 1144768821 | Rebekah J Labouff | Nurse Practitioner | 6465 S Yale Ave Ste 320, Tulsa, OK 74136-7805 | 2017-02-02 |
| Find all providers with the same taxonomy | ||||
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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.