Organization Active NPI

Prime Health Associates, PLLC

  • Family Medicine Physician
  • Edmond, OK
National Provider Identifier
1093312548
Registry record updated Oct 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PRIME HEALTH ASSOCIATES, PLLC
Practice address
2511 Alexa Ave
Edmond, OK 73034-3458
Phone
(405) 822-0130
NPI assigned
Oct 7, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2020

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

Authorized official

Name
Kevin White, MD
Title
MD/Owner
Phone
(405) 822-0130

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Clinic/Center 261Q00000X
Health Service Clinic/Center 261QH0100X
Infusion Therapy Clinic/Center 261QI0500X
Medical Specialty Clinic/Center 261QM2500X
Primary Care Clinic/Center 261QP2300X

Addresses

Primary practice location

2511 Alexa Ave
Edmond, OK 73034-3458

Mailing address

2511 Alexa Ave
Edmond, OK 73034-3458
Phone (405) 822-0130

Other identifiers 1

IdentifierTypeStateIssuer
1689696858MedicaidOK

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL ehr

National Provider Directory

National Provider Directory

Locations

902 NW 139th Street Pkwy
Edmond, OK 73013
Phone (405) 778-0700

NPI Registry JSON

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

{
    "created_epoch": "1602028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602028800000",
    "number": "1093312548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2511 ALEXA AVE",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730343458",
            "telephone_number": "405-822-0130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2511 ALEXA AVE",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730343458",
            "telephone_number": "405-822-0130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME HEALTH ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-07",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "405-822-0130",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689696858",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ehr",
            "affiliation": "N",
            "address_1": "2511 Alexa Ave",
            "city": "Edmond",
            "state": "OK",
            "country_code": "US",
            "postal_code": "730343458",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; 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.