NPIMap

Organization Active NPI

Saints Medical Group, LLC

Doing business as SSM Health Medical Group Purcell

  • Family Medicine Physician
  • Purcell, OK
National Provider Identifier
1043852940
Registry record updated Oct 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SAINTS MEDICAL GROUP, LLC
Doing business as
SSM Health Medical Group Purcell
Practice address
1401 N 4TH Ave Ste 107
Purcell, OK 73080-1806
Phone
(405) 527-5400
Fax
(405) 527-7332
NPI assigned
Oct 11, 2019
Last updated
Oct 11, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
SSM HEALTH CARE OF OKLAHOMA, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 11, 2019

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

Authorized official

Name
Crystal L Pena
Title
Provider Enrollment/Ins Credential
Phone
(405) 272-7452

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

1401 N 4TH Ave Ste 107
Purcell, OK 73080-1806

Mailing address

1401 N 4TH Ave Ste 107
Purcell, OK 73080-1806
Phone (405) 527-5400

Other names 1

  • SSM Health Medical Group Purcell Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Saints Medical Group114 organizations share this tax ID, including this one
Part of
SSM Healthcare of Ok in

Organizations with this tax ID in the same state 18

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

View all 18

Locations

1401 N 4th Ave
Ste 107
Purcell, OK 73080
Phone (405) 527-5400

999 Hospital Dr
Purcell, OK 73080
Phone (405) 803-5010

NPI Registry JSON

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

{
    "created_epoch": "1570752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570752000000",
    "number": "1043852940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 N 4TH AVE STE 107",
            "city": "PURCELL",
            "state": "OK",
            "postal_code": "730801806",
            "telephone_number": "405-527-5400",
            "fax_number": "405-527-7332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 N 4TH AVE STE 107",
            "city": "PURCELL",
            "state": "OK",
            "postal_code": "730801806",
            "telephone_number": "405-527-5400",
            "fax_number": "405-527-7332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINTS MEDICAL GROUP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SSM HEALTH CARE OF OKLAHOMA, INC",
        "enumeration_date": "2019-10-11",
        "last_updated": "2019-10-11",
        "status": "A",
        "authorized_official_last_name": "PENA",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT/INS CREDENTIAL",
        "authorized_official_telephone_number": "405-272-7452"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SSM Health Medical Group Purcell",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Purcell, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2019; 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.