Organization Active NPI

Family Medicine Associates of Edmond LLC

  • Clinic/Center
  • Edmond, OK
National Provider Identifier
1093940454
Registry record updated Jul 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
FAMILY MEDICINE ASSOCIATES OF EDMOND LLC
Practice address
105 S Bryant Ave Ste 210
Edmond, OK 73034-6331
Phone
(405) 359-5229
Fax
(405) 359-5214
NPI assigned
May 28, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2019

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

Authorized official

Name
Stephanie Jones
Title
Director of Patient Accounting
Phone
(405) 271-7099

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

105 S Bryant Ave Ste 210
Edmond, OK 73034-6331

Mailing address

PO Box 744499
Atlanta, GA 30374-4499
Phone (405) 271-8132

Other identifiers 1

IdentifierTypeStateIssuer
200249490AMedicaidOK

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

3824 S Boulevard
Ste 160
Edmond, OK 73013
Phone (405) 348-2424

105 S Bryant Ave
Ste 104
Edmond, OK 73034
Phone (405) 216-0956

NPI Registry JSON

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

{
    "created_epoch": "1243468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563148800000",
    "number": "1093940454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 744499",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303744499",
            "telephone_number": "405-271-8132",
            "fax_number": "405-271-5006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 S BRYANT AVE STE 210",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730346331",
            "telephone_number": "405-359-5229",
            "fax_number": "405-359-5214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICINE ASSOCIATES OF EDMOND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-28",
        "last_updated": "2019-07-15",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "DIRECTOR OF PATIENT ACCOUNTING",
        "authorized_official_telephone_number": "405-271-7099"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200249490A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "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 Jul 15, 2019; 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.