Individual provider Active NPI

Michael Morgan, MD

  • Family Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1063456242
Registry record updated Aug 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
17483 Issued in OK
Practice address
4221 S Western Ave
Suite 3030
Oklahoma City, OK 73109-3447
Phone
(405) 636-7650
Fax
(405) 636-7743
NPI assigned
Jun 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 17483 OK Primary

Addresses

Primary practice location

4221 S Western Ave
Suite 3030
Oklahoma City, OK 73109-3447

Mailing address

5300 N Independence Ave
Suite 280
Oklahoma City, OK 73112-5556
Phone (405) 636-7650

Other identifiers 1

IdentifierTypeStateIssuer
100141820BMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041216000037 OK Practitioner - Family Practice 1153387238 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Integris Ambulatory Care Corporation Family Medicine CurrentSince Jan 1, 2005 Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

5300 N Independence Ave
Ste 280
Oklahoma City, OK 73112
Phone (405) 552-0155

3400 NW Expressway
Ste 500
Oklahoma City, OK 73112
Phone (405) 945-4589

4221 S Western Ave
Ste 3030
Oklahoma City, OK 73109
Phone (405) 636-7650

4221 S Western Ave
Oklahoma City, OK 73109
Phone (405) 636-7000

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502323200000",
    "number": "1063456242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 N INDEPENDENCE AVE",
            "address_2": "SUITE 280",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731125556",
            "telephone_number": "405-636-7650",
            "fax_number": "405-636-7743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4221 S WESTERN AVE",
            "address_2": "SUITE 3030",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731093447",
            "telephone_number": "405-636-7650",
            "fax_number": "405-636-7743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORGAN",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2017-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "17483",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100141820B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.