Individual provider Active NPI

Cory D Nagode, M.D.

  • Family Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1093755803
Registry record updated Jul 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
15316 Issued in OK
Practice address
1600 SW 119TH St
Oklahoma City, OK 73170-4908
Phone
(405) 425-8100
Fax
(405) 425-8109
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 15316 OK Primary

Addresses

Primary practice location

1600 SW 119TH St
Oklahoma City, OK 73170-4908

Mailing address

5300 N Independence Ave
Suite 280
Oklahoma City, OK 73112-5556
Phone (405) 425-8100

Other identifiers 1

IdentifierTypeStateIssuer
100736700QMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500422400000",
    "number": "1093755803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 N INDEPENDENCE AVE",
            "address_2": "SUITE 280",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731125556",
            "telephone_number": "405-425-8100",
            "fax_number": "405-425-8109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW 119TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731704908",
            "telephone_number": "405-425-8100",
            "fax_number": "405-425-8109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAGODE",
        "first_name": "CORY",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2017-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "15316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100736700Q",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2017; 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.