Organization Active NPI

Westport Family Medicine, PLLC

  • Family Medicine Physician
  • Norman, OK
National Provider Identifier
1033145370
Registry record updated Jul 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
3845 Issued in OK
Legal business name
WESTPORT FAMILY MEDICINE, PLLC
Practice address
2400 Palmer Cir
Norman, OK 73069-6301
Phone
(405) 321-6405
Fax
(405) 321-6457
NPI assigned
Jun 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2008

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

Authorized official

Name
Jim D Davis, DONPI 1780675975
Title
Partner
Phone
(405) 321-6405

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: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 3845 OK Primary

Addresses

Primary practice location

2400 Palmer Cir
Norman, OK 73069-6301

Mailing address

PO Box 268822
Oklahoma City, OK 73126-8822
Phone (405) 321-6405

Other identifiers 1

IdentifierTypeStateIssuer
200074650AMedicaidOK

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1151193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217376000000",
    "number": "1033145370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 268822",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731268822",
            "telephone_number": "405-321-6405",
            "fax_number": "405-321-6457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 PALMER CIR",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730696301",
            "telephone_number": "405-321-6405",
            "fax_number": "405-321-6457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTPORT FAMILY MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-25",
        "last_updated": "2008-07-30",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "JIM",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "405-321-6405",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "3845",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200074650A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norman, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2008; 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.