NPIMap

Organization Active NPI

Board of Regents of the Univ of Oklahoma-Ou Physicians Adolescent Med

  • Clinic/Center
  • Okc, OK
National Provider Identifier
1013005388
Registry record updated Sep 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
BOARD OF REGENTS OF THE UNIV OF OKLAHOMA-OU PHYSICIANS ADOLESCENT MED
Practice address
1200 Children's Avenue
Suite 7500
Okc, OK 73104
Phone
(405) 271-2006
NPI assigned
Oct 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2012

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

Authorized official

Name
Brian Maddy
Title
Chief Executive Officer
Phone
(405) 271-1515

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

1200 Children's Avenue
Suite 7500
Okc, OK 73104

Mailing address

1122 NE 13
Ori236
Okc, OK 73117
Phone (405) 271-1515

Other identifiers 1

IdentifierTypeStateIssuer
200021910AMedicaidOK

Other names 1

  • OU Physicians Adolescent Medicine Other name

National Provider Directory

National Provider Directory
Tax ID family
Board of Regents of the Univ of Oklahoma-Ou Phys Orl38 organizations share this tax ID, including this one

Other organizations with this tax ID 37

Organizations that report the same tax identification number in the National Provider Directory.

View all 37

Locations

1200 Childrens Ave
Ste 7500
Oklahoma City, OK 73104
Phone (405) 271-2006

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346889600000",
    "number": "1013005388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 NE 13",
            "address_2": "ORI236",
            "city": "OKC",
            "state": "OK",
            "postal_code": "73117",
            "telephone_number": "405-271-1515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 CHILDREN'S AVENUE",
            "address_2": "SUITE 7500",
            "city": "OKC",
            "state": "OK",
            "postal_code": "73104",
            "telephone_number": "405-271-2006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOARD OF REGENTS OF THE UNIV OF OKLAHOMA-OU PHYSICIANS ADOLESCENT MED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2012-09-06",
        "status": "A",
        "authorized_official_last_name": "MADDY",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "405-271-1515"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200021910A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OU Physicians Adolescent Medicine",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Okc, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.