Organization Active NPI

Doney Medical, Inc.

  • Medical Specialty Clinic/Center
  • Miami, OK
National Provider Identifier
1104900554
Registry record updated Apr 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
11653 Issued in OK
Legal business name
DONEY MEDICAL, INC.
Practice address
310 2ND Ave SW
Suite 201
Miami, OK 74354-6702
Phone
(918) 542-8477
Fax
(918) 542-6422
NPI assigned
Oct 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2023

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

Authorized official

Name
Dr. Jack R. Doney, M.D.NPI 1518927664
Title
Physician
Phone
(918) 542-8477

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 11653 OK
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X 11653 OK
Medical Specialty Clinic/Center 261QM2500X 11653 OK Primary

Addresses

Primary practice location

310 2ND Ave SW
Suite 201
Miami, OK 74354-6702

Mailing address

310 2ND Ave SW
Suite 201
Miami, OK 74354-6702
Phone (918) 542-8477

Other identifiers 2

IdentifierTypeStateIssuer
100209450AMedicaidOK
100735640AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050111000955 OK Part B Supplier - Clinic/Group Practice 3173571668 Receives reassigned benefits from 2 practitioners
Practice locations: Miami, OK

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D0688982Doney Medical Inc310 2ND SW Suite 201, Miami, OK 74354Provider-performed microscopyAug 31, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681171200000",
    "number": "1104900554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 2ND AVE SW",
            "address_2": "SUITE 201",
            "city": "MIAMI",
            "state": "OK",
            "postal_code": "743546702",
            "telephone_number": "918-542-8477",
            "fax_number": "918-542-6422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 2ND AVE SW",
            "address_2": "SUITE 201",
            "city": "MIAMI",
            "state": "OK",
            "postal_code": "743546702",
            "telephone_number": "918-542-8477",
            "fax_number": "918-542-6422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DONEY MEDICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A",
        "authorized_official_last_name": "DONEY",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "918-542-8477",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "11653",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "OK",
            "license": "11653",
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "OK",
            "license": "11653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100209450A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100735640A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.