NPIMap

Organization Active NPI

Saint Medical Group, LLC

Doing business as SSM Health Behavioral Health Edmond

  • Psychiatry Physician
  • Edmond, OK
National Provider Identifier
1023699956
Registry record updated Apr 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
SAINT MEDICAL GROUP, LLC
Doing business as
SSM Health Behavioral Health Edmond
Practice address
416 W 15TH St
Edmond, OK 73013-3747
Phone
(405) 513-8535
NPI assigned
Apr 21, 2021
Last updated
Apr 21, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
SSM HEALTH CARE OF OKLAHOMA, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 21, 2021

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

Authorized official

Name
Crystal L Pena
Title
Credentialing Specialist
Phone
(405) 272-7452

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary
Multi-Specialty Clinic/Center 261QM1300X

Addresses

Primary practice location

416 W 15TH St
Edmond, OK 73013-3747

Mailing address

416 W 15TH St
Edmond, OK 73013-3747
Phone (405) 513-8535

Other names 1

  • SSM Health Behavioral Health Edmond 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
SSM Healthcare of Ok in

Organizations with this tax ID in the same state 15

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

View all 15

Locations

416 W 15th St
Edmond, OK 73013
Phone (405) 513-8535

NPI Registry JSON

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

{
    "created_epoch": "1618963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618963200000",
    "number": "1023699956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 W 15TH ST",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730133747",
            "telephone_number": "405-513-8535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 W 15TH ST",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730133747",
            "telephone_number": "405-513-8535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT MEDICAL GROUP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SSM HEALTH CARE OF OKLAHOMA, INC.",
        "enumeration_date": "2021-04-21",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A",
        "authorized_official_last_name": "PENA",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "405-272-7452"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SSM Health Behavioral Health Edmond",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Edmond, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 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.