Lydia J Dennis, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4514 Issued in OK

Practice address

520 S Mustang Rd
Yukon, OK 73099-6737

Phone

(405) 936-5910

Fax

(405) 577-2605

NPI assigned

Aug 30, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 19, 2019 through Apr 19, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lydia.dennis@212632001642500.direct.elationemr.com

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.

• Vibrant Life Direct Care, PLLC

  • Family Medicine Physician
  • Mustang, OK
  • NPI 1295365302
  NPD Authorized official
• Vibrant Life Direct Care, PLLC

  • Primary Care Clinic/Center
  • Tuttle, OK
  • NPI 1730880212
  NPD Authorized official
• Jackson County Memorial Hospital Authority

  • General Acute Care Hospital
  • Altus, OK
  • NPI 1093763781
  NPD (past)
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)
• Emergency Services of Kansas, PA

  • Internal Medicine Physician
  • Newton, KS
  • NPI 1104864503

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398643200000",
    "number": "1083724546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 W MEMORIAL RD",
            "address_2": "140",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731341785",
            "telephone_number": "405-752-3162",
            "fax_number": "405-936-5211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S MUSTANG RD",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730996737",
            "telephone_number": "405-936-5910",
            "fax_number": "405-577-2605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENNIS",
        "first_name": "LYDIA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2014-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "4514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyler Christian Deckard, PHARMD
• Ali Lynann Decker
• Gabrielle Leigh Deleon
• Sandra Deloera
• Gregory J Dennis, DO
• Dental Depot of Piedmont, PLLC
• Dental Depot Orthodontics Yukon PLLC
• Dental Professionals of Oklahoma, P.C.
• Dentistry by Design, P.C.
• Dentures, Implants, and Dentistry of Oklahoma PLLC

• Family Medicine Physician in Yukon, OK
• Providers in Yukon, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.