| Mr Brian Travis Pendarvis, ARNP | |
|
205 South Main Street, Noble, OK 73068 | |
| (405) 872-5403 | |
| (405) 872-5407 |
| Full Name | Mr Brian Travis Pendarvis |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner |
| Experience | 22 Years |
| Location | 205 South Main Street, Noble, Oklahoma |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417952904 | NPI | - | NPPES |
| 200043980A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | R0067224 (Oklahoma) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Norman Regional | Norman, OK | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Noble Family Healthcare Clinic | 3476569435 | 3 |
| Entity Name | Noble Family Healthcare Clinic |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1447327622 PECOS PAC ID: 3476569435 Enrollment ID: O20060228000513 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Brian Travis Pendarvis, ARNP 205 South Main Street, Po Box 2096, Noble, OK 73068 Ph: (405) 872-5403 | Mr Brian Travis Pendarvis, ARNP 205 South Main Street, Noble, OK 73068 Ph: (405) 872-5403 |
Emily J Shockley, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1501 N 8th St, Noble, OK 73068 Phone: 405-872-7102 | |
Drew W Woodrow, DNP, APRN, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 8201 102nd St, Noble, OK 73068 Phone: 405-370-3139 | |
Dawnita R Randolph, MSN, APRN, NP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 8703 80th St, Noble, OK 73068 Phone: 405-820-5857 |