NPIMap

Organization Active NPI

Community Physicians Group

  • Family Medicine Physician
  • Westville, OK
National Provider Identifier
1043493992
Registry record updated Dec 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
COMMUNITY PHYSICIANS GROUP
Practice address
419 S Williams
Westville, OK 74965
Phone
(918) 723-5456
Fax
(918) 723-4080
NPI assigned
Dec 14, 2007
Last updated
Dec 4, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2009

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

Authorized official

Name
Kelly E Chambers
Title
Billing Manager
Phone
(479) 549-3079

Specialties & licenses 1

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

Addresses

Primary practice location

419 S Williams
Westville, OK 74965

Mailing address

PO Box 1374
Siloam Springs, AR 72761-1374
Phone (479) 549-3079

Other identifiers 5

IdentifierTypeStateIssuer
CI2712OtherOKRR MEDICARE
135299002MedicaidAR
5C090OtherARBCBS
100747540AMedicaidOK
CI2710OtherARRR MEDICARE

National Provider Directory

National Provider Directory

Locations

451 S Holly St
#2712
Siloam Spgs, AR 72761

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AGBFAD

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1197590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259884800000",
    "number": "1043493992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1374",
            "city": "SILOAM SPRINGS",
            "state": "AR",
            "postal_code": "727611374",
            "telephone_number": "479-549-3079",
            "fax_number": "479-549-3275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 S WILLIAMS",
            "city": "WESTVILLE",
            "state": "OK",
            "postal_code": "74965",
            "telephone_number": "918-723-5456",
            "fax_number": "918-723-4080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY PHYSICIANS GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-14",
        "last_updated": "2009-12-04",
        "status": "A",
        "authorized_official_last_name": "CHAMBERS",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "479-549-3079"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CI2712",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135299002",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5C090",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100747540A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CI2710",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westville, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2009; 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.