NPIMap

Organization Active NPI

Saint Medical Group, LLC

Doing business as SSM Health Medical Group Otology

  • Otology & Neurotology Physician
  • Oklahoma City, OK
National Provider Identifier
1013506997
Registry record updated Jan 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otology & Neurotology PhysicianTaxonomy code 207YX0901X
Legal business name
SAINT MEDICAL GROUP, LLC
Doing business as
SSM Health Medical Group Otology
Practice address
3400 NW 56TH St
Oklahoma City, OK 73112-4463
Phone
(405) 946-5563
Fax
(405) 947-6226
NPI assigned
Jan 14, 2021
Organization subpart
Yes
Parent organization
SSM HEALTH CARE OF OKLAHOMA, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 14, 2021

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

Authorized official

Name
Crystal L Pena
Title
Provider Enrollment Coordinator
Phone
(405) 272-7452

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otology & Neurotology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207YX0901X Primary
AudiologistGroup: 193200000X MULTI-SPECIALTY GROUP 231H00000X

Addresses

Primary practice location

3400 NW 56TH St
Oklahoma City, OK 73112-4463

Mailing address

3400 NW 56TH St
Oklahoma City, OK 73112-4463
Phone (405) 946-5563

Other names 1

  • SSM Health Medical Group Otology Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Saints Medical Group LLC114 organizations share this tax ID, including this one
Part of
24 Saints Physical the

Organizations with this tax ID in the same state 13

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1610582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610582400000",
    "number": "1013506997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 NW 56TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124463",
            "telephone_number": "405-946-5563",
            "fax_number": "405-947-6226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 NW 56TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124463",
            "telephone_number": "405-946-5563",
            "fax_number": "405-947-6226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT MEDICAL GROUP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SSM HEALTH CARE OF OKLAHOMA, INC",
        "enumeration_date": "2021-01-14",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A",
        "authorized_official_last_name": "PENA",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT COORDINATOR",
        "authorized_official_telephone_number": "405-272-7452"
    },
    "taxonomies": [
        {
            "code": "207YX0901X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Otology & Neurotology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SSM Health Medical Group Otology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2021; 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.