NPIMap

Organization Active NPI

Saints Medical Group

Doing business as Saints Dermatology Enid

  • Dermatology Physician
  • Enid, OK
National Provider Identifier
1093013948
Registry record updated Jul 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
SAINTS MEDICAL GROUP
Doing business as
Saints Dermatology Enid
Practice address
330 S 5TH St
Suite 400
Enid, OK 73701-5825
Phone
(580) 242-2386
Fax
(580) 233-5312
NPI assigned
Mar 2, 2011
Last updated
Jul 29, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
SSM HEALTHCARE OF OK, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 29, 2011

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

Authorized official

Name
Ms. Crystal L Pena
Title
Credentialing Specialist
Phone
(405) 272-7452

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU Primary

Addresses

Primary practice location

330 S 5TH St
Suite 400
Enid, OK 73701-5825

Mailing address

330 S 5TH St
Suite 400
Enid, OK 73701-5825
Phone (580) 242-2386

Other names 1

  • Saints Dermatology Enid Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Saints Medical Group LLC114 organizations share this tax ID, including this one
Part of
SSM Healthcare of Ok in

Organizations with this tax ID in the same state 23

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

View all 23

Locations

330 S 5th St
Ste 400
Enid, OK 73701
Phone (580) 234-7320

NPI Registry JSON

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

{
    "created_epoch": "1299024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311897600000",
    "number": "1093013948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 S 5TH ST",
            "address_2": "SUITE 400",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737015825",
            "telephone_number": "580-242-2386",
            "fax_number": "580-233-5312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 S 5TH ST",
            "address_2": "SUITE 400",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737015825",
            "telephone_number": "580-242-2386",
            "fax_number": "580-233-5312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINTS MEDICAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SSM HEALTHCARE OF OK, INC",
        "enumeration_date": "2011-03-02",
        "last_updated": "2011-07-29",
        "status": "A",
        "authorized_official_last_name": "PENA",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "405-272-7452",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Saints Dermatology Enid",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Enid, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2011; 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.