Active NPI
Edgar Garcia
- Peer Specialist
- Ponca City, OK
National Provider Identifier
1114550779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- V083370953
- Practice address
- 2225 N Union St
Ponca City, OK 74601-1555 - Phone
- (580) 749-5056
- NPI assigned
- Feb 21, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | V083370953 | OK | Primary |
Addresses
Primary practice location
2225 N Union St
Ponca City, OK 74601-1555
Mailing address
1600 N 4TH St
Ponca City, OK 74601-2741
Phone (580) 491-3119
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| V083370953 | OK | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1582243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585180800000",
"number": "1114550779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 N 4TH ST",
"city": "PONCA CITY",
"state": "OK",
"postal_code": "746012741",
"telephone_number": "580-491-3119"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2225 N UNION ST",
"city": "PONCA CITY",
"state": "OK",
"postal_code": "746011555",
"telephone_number": "580-749-5056"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARCIA",
"first_name": "EDGAR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-02-21",
"last_updated": "2020-03-26",
"certification_date": "2020-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "OK",
"license": "V083370953",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ponca City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.