NPIMap

Organization Active NPI

Dynamic Physician Group LLC

  • Family Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1033077078
Registry record updated May 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DYNAMIC PHYSICIAN GROUP LLC
Practice address
2200 Shadowlake Dr
Oklahoma City, OK 73159-7440
Phone
(405) 554-3344
Fax
(405) 694-4547
NPI assigned
Jan 9, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2026

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

Authorized official

Name
Jeanie Marie LoperNPI 1750424404
Title
MD
Phone
(580) 916-2494

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)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

2200 Shadowlake Dr
Oklahoma City, OK 73159-7440

Mailing address

2200 Shadowlake Dr
Oklahoma City, OK 73159-7440
Phone (405) 342-0143

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1767916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779926400000",
    "number": "1033077078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 SHADOWLAKE DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731597440",
            "telephone_number": "405-342-0143",
            "fax_number": "405-260-8784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 SHADOWLAKE DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731597440",
            "telephone_number": "405-554-3344",
            "fax_number": "405-694-4547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC PHYSICIAN GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-09",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A",
        "authorized_official_last_name": "LOPER",
        "authorized_official_first_name": "JEANIE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "580-916-2494"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 May 28, 2026; 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.