NPIMap

Organization Active NPI

Oklahoma Emergency Services PC

  • Emergency Medicine Physician
  • Lawton, OK
National Provider Identifier
1114239795
Registry record updated Jan 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
OKLAHOMA EMERGENCY SERVICES PC
Practice address
3401 W Gore Blvd
Lawton, OK 73505-6332
Phone
(925) 924-1600
Fax
(925) 924-0506
NPI assigned
Jul 12, 2010
Last updated
Jan 10, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2020

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

Authorized official

Name
Kristopher M. Smith
Title
Cfo
Phone
(925) 251-6933

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X Primary
Physician Assistant 363A00000X
Nurse Practitioner 363L00000X

Addresses

Primary practice location

3401 W Gore Blvd
Lawton, OK 73505-6332

Mailing address

5000 Hopyard Rd
Suite 100
Pleasanton, CA 94588-3348
Phone (925) 924-1600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110411000211 OK Part B Supplier - Clinic/Group Practice 3678757010 Receives reassigned benefits from 124 practitioners
Practice locations: Oklahoma City, OK

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 157

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 157

NPI Registry JSON

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

{
    "created_epoch": "1278892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578614400000",
    "number": "1114239795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 HOPYARD RD",
            "address_2": "SUITE 100",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945883348",
            "telephone_number": "925-924-1600",
            "fax_number": "925-924-0506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 W GORE BLVD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056332",
            "telephone_number": "925-924-1600",
            "fax_number": "925-924-0506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OKLAHOMA EMERGENCY SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-12",
        "last_updated": "2020-01-10",
        "certification_date": "2020-01-10",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KRISTOPHER",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "925-251-6933"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawton, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.