Active NPI
Ronald Fried, D.O.
- Family Medicine Physician
- Wewoka, OK
National Provider Identifier
1093714214
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 33626
- Practice address
- Hwy 56 & 270 Junction
Wewoka, OK 74884-1475 - Phone
- (405) 257-7318
- Fax
- (405) 257-2696
- NPI assigned
- Jul 19, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 33626 | MO | Primary |
Addresses
Primary practice location
Hwy 56 & 270 Junction
Wewoka, OK 74884-1475
Mailing address
PO Box 1475
Wewoka, OK 74884-1475
Phone (405) 257-7318
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1201685 | Medicaid | OK |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33626 | MO | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wewoka Indian Health | Current | Accepting new patients | |
| Plaza Medical Group PC | Family Medicine | Past | Accepting new patients |
Locations
36640 Highway 270
#C
Wewoka, OK 74884
Phone (405) 257-6282
Organizations & group practices 2
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.
-
- Cardiovascular Disease Physician
- Oklahoma City, OK
- NPI 1295731792
Family Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319673600000",
"number": "1093714214",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1475",
"city": "WEWOKA",
"state": "OK",
"postal_code": "748841475",
"telephone_number": "405-257-7318",
"fax_number": "405-257-2696"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "HWY 56 & 270 JUNCTION",
"city": "WEWOKA",
"state": "OK",
"postal_code": "748841475",
"telephone_number": "405-257-7318",
"fax_number": "405-257-2696"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRIED",
"first_name": "RONALD",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-19",
"last_updated": "2011-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MO",
"license": "33626",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1201685",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wewoka, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2011; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.