Individual provider Active NPI

McKenna Wayne Box

  • Student in an Organized Health Care Education/Training Program
  • Edmond, OK
National Provider Identifier
1093317596
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
14025 N Eastern Ave Apt 1816
Edmond, OK 73013-5767
Phone
(405) 626-1647
NPI assigned
Nov 10, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X OK Primary

Addresses

Primary practice location

14025 N Eastern Ave Apt 1816
Edmond, OK 73013-5767

Mailing address

14025 N Eastern Ave Apt 1816
Edmond, OK 73013-5767
Phone (405) 626-1647

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240403002571 TX Order and Referring Only - Orthopedic SurgeryPractitioner - Orthopedic Surgery 7618315144

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: mckenna.box@hca7.eclinicaldirectplus.com

NPI Registry JSON

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

{
    "created_epoch": "1604966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1093317596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14025 N EASTERN AVE APT 1816",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730135767",
            "telephone_number": "405-626-1647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14025 N EASTERN AVE APT 1816",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730135767",
            "telephone_number": "405-626-1647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOX",
        "first_name": "MCKENNA",
        "middle_name": "WAYNE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-10",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

Verify at the official NPI Registry.