Active NPI
Naga M Javvaji MD PC
- Specialist
- Muskogee, OK
National Provider Identifier
1003948290
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 18659
- Legal business name
- NAGA M JAVVAJI MD PC
- Practice address
- 333 S 38TH St Ste a
Muskogee, OK 74401-4937 - Phone
- (918) 682-8631
- Fax
- (918) 686-7078
- NPI assigned
- Mar 12, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Naga M Javvaji, M.D.
- Title
- Owner
- Phone
- (918) 682-8631
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 18659 | OK | Primary |
Addresses
Primary practice location
333 S 38TH St Ste a
Muskogee, OK 74401-4937
Mailing address
333 S 38TH St Ste a
Muskogee, OK 74401-4937
Phone (918) 682-8631
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050228000039 | OK | Part B Supplier - Clinic/Group Practice | 1456319722 |
Receives reassigned benefits from 2 practitioners Practice locations: Muskogee, OK |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173657600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1003948290",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "333 S 38TH ST STE A",
"city": "MUSKOGEE",
"state": "OK",
"postal_code": "744014937",
"telephone_number": "918-682-8631",
"fax_number": "918-686-7078"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 S 38TH ST STE A",
"city": "MUSKOGEE",
"state": "OK",
"postal_code": "744014937",
"telephone_number": "918-682-8631",
"fax_number": "918-686-7078"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NAGA M JAVVAJI MD PC",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-12",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "JAVVAJI",
"authorized_official_first_name": "NAGA",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "918-682-8631",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist",
"state": "OK",
"license": "18659",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Muskogee, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.