NPIMap

Individual provider Active NPI

Joshua Medved, D.O.

  • Emergency Medicine Physician
  • Ada, OK
National Provider Identifier
1104266659
Registry record updated Sep 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
5410 Issued in OK
Practice address
1921 Stonecipher Blvd
Ada, OK 74820
Phone
(580) 421-4570
NPI assigned
Jun 28, 2013
Last updated
Sep 14, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 5410 OK Primary

Addresses

Primary practice location

1921 Stonecipher Blvd
Ada, OK 74820

Mailing address

1921 Stonecipher Blvd
Ada, OK 74820
Phone (580) 421-4570

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140114000627 OK Practitioner - Emergency Medicine 0648408971 Reassigns benefits to 3 organizations
I20150527002215 TX Practitioner - Emergency Medicine 0648408971 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1921 Stonecipher Dr
Ada, OK 74820-3439
Phone (580) 436-3980

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5410OKMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Kingfisher, Inc Current Accepting new patients
Emergency Services of Oklahoma PC Emergency Medicine CurrentSince Jul 1, 2014 Accepting new patients
Chickasaw Nation Division of Health Current Accepting new patients
Chickasaw Nation Division of Health Chickasaw Nation Medical Center CurrentSince Apr 14, 2015 Accepting new patients
Oklahoma Emergency Physician Partners PLLC Emergency Medicine Current Accepting new patients
Chickasaw Nation Division of Health CurrentSince Apr 14, 2015 Accepting new patients

Locations

1921 Stonecipher Dr
Ada, OK 74820
Phone (580) 421-4570

2510 Chickasaw Blvd
Ardmore, OK 73401
Phone (580) 226-8181

1800 W University Blvd
Durant, OK 74701
Phone (580) 924-3080

4050 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 608-3200

1438 Hardcastle Blvd
Purcell, OK 73080
Phone (405) 527-4700

817 E 6th St
Tishomingo, OK 73460
Phone (580) 371-2392

Interoperability endpoints

  • Direct secure messaging: jmedved21185@direct.chickasawnationhealth.net

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1372377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473811200000",
    "number": "1104266659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1921 STONECIPHER BLVD",
            "city": "ADA",
            "state": "OK",
            "postal_code": "74820",
            "telephone_number": "580-421-4570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 STONECIPHER BLVD",
            "city": "ADA",
            "state": "OK",
            "postal_code": "74820",
            "telephone_number": "580-421-4570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDVED",
        "first_name": "JOSHUA",
        "name_prefix": "Mr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-28",
        "last_updated": "2016-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "5410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ada, OK

Sources for this page

Verify at the official NPI Registry.