Organization Active NPI

Plastic Surgery & Dermatology Associates, PLLC

  • Plastic Surgery Physician
  • Oklahoma City, OK
National Provider Identifier
1023020864
Registry record updated Sep 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
PLASTIC SURGERY & DERMATOLOGY ASSOCIATES, PLLC
Practice address
2520 NW Expressway
Suite #1010
Oklahoma City, OK 73112-7163
Phone
(405) 942-4300
Fax
(405) 942-4312
NPI assigned
Aug 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2014

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

Authorized official

Name
Julie B. Lowe, M.D.
Title
Co-Owner
Phone
(405) 942-4300

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X
Plastic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208200000X Primary
Surgery of the Hand (Plastic Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2082S0105X
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X

Addresses

Primary practice location

2520 NW Expressway
Suite #1010
Oklahoma City, OK 73112-7163

Mailing address

Dept. #96-0284
Oklahoma City, OK 73196-0284
Phone (405) 286-9740

Other identifiers 1

IdentifierTypeStateIssuer
200084420AMedicaidOK

National Provider Directory

National Provider Directory

Locations

Dept 960284
Oklahoma City, OK 73196

4200 W Memorial Rd
Ste 1010
Oklahoma City, OK 73120
Phone (405) 749-4227

14000 N Portland Ave
Oklahoma City, OK 73134
Phone (405) 608-1700

2520 N West Expy
Ste 1010
Oklahoma City, OK 73112
Phone (405) 942-4300

Practitioners & affiliated clinicians

Practitioners 3

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": "1155340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411689600000",
    "number": "1023020864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT. #96-0284",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731960284",
            "telephone_number": "405-286-9740",
            "fax_number": "405-753-5428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 NW EXPRESSWAY",
            "address_2": "SUITE #1010",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731127163",
            "telephone_number": "405-942-4300",
            "fax_number": "405-942-4312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLASTIC SURGERY & DERMATOLOGY ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-12",
        "last_updated": "2014-09-26",
        "status": "A",
        "authorized_official_last_name": "LOWE",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "405-942-4300",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2082S0105X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200084420A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Sep 26, 2014; 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.