Organization Active NPI

Schafer Medical PLLC

  • Family Medicine Physician
  • Ardmore, OK
National Provider Identifier
1093291601
Registry record updated Jul 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4352 Issued in OK
Legal business name
SCHAFER MEDICAL PLLC
Practice address
800 Isabel St
Ardmore, OK 73401-5118
Phone
(580) 223-5432
Fax
(580) 223-6076
NPI assigned
Jul 17, 2018
Last updated
Jul 8, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2020

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

Authorized official

Name
Dr. Ryan Wilson Schafer, DONPI 1780650606
Title
President
Phone
(580) 319-1410

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4352 OK Primary

Addresses

Primary practice location

800 Isabel St
Ardmore, OK 73401-5118

Mailing address

800 Isabel St
Ardmore, OK 73401-5118
Phone (580) 223-5432

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181024000214 OK Part B Supplier - Clinic/Group Practice 5496008351 Receives reassigned benefits from 1 practitioner
Practice locations: Ardmore, OK

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D0471917Schafer Medical Center800 Isabel SW, Ardmore, OK 73401ComplianceMay 22, 2028

National Provider Directory

National Provider Directory

Locations

720 N Commerce St
#686
Ardmore, OK 73401

Practitioners & affiliated clinicians

Practitioners 1

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": "1531785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594166400000",
    "number": "1093291601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 ISABEL ST",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734015118",
            "telephone_number": "580-223-5432",
            "fax_number": "580-223-6076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 ISABEL ST",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734015118",
            "telephone_number": "580-223-5432",
            "fax_number": "580-223-6076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCHAFER MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-17",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A",
        "authorized_official_last_name": "SCHAFER",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "WILSON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "580-319-1410",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "4352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ardmore, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.