Individual provider Active NPI

Lata B Vad, M.D.

  • Psychiatry Physician
  • Oklahoma City, OK
National Provider Identifier
1124069059
Registry record updated Sep 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
13502 Issued in OK
Practice address
2129 SW 59TH St
Oklahoma City, OK 73119-7024
Phone
(405) 685-6671
NPI assigned
Jun 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 13502 OK Primary

Addresses

Primary practice location

2129 SW 59TH St
Oklahoma City, OK 73119-7024

Mailing address

3801 NW 63Rd St
Suite 160
Oklahoma City, OK 73116-1921
Phone (405) 858-0600

Other identifiers 1

IdentifierTypeStateIssuer
100019370AMedicaidOK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090218000224 OK Practitioner - Psychiatry 6709941149 Reassigns benefits to 1 organization
Practice locations: Oklahoma City, OK

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care of Oklahoma Inc CurrentSince Dec 1, 2013 Accepting new patients
SSM Health Care of Oklahoma, Inc. CurrentSince Dec 1, 2013 Accepting new patients
SSM Health Care of Oklahoma, Inc Current Accepting new patients
Quyen Ha MD PC Past Accepting new patients
Saints Medical Group, LLC Past Accepting new patients

Locations

7106 Solutions Ctr
Chicago, IL 60677

3801 NW 63rd St
Ste 160
Oklahoma City, OK 73116

1000 N Lee Ave
Oklahoma City, OK 73102
Phone (405) 272-6152

608 NW 9th St
Ste 2200
Oklahoma City, OK 73102
Phone (405) 231-3737

608 NW 9th St
Ste 1100
Oklahoma City, OK 73102
Phone (405) 231-3000

2129 SW 59th St
Oklahoma City, OK 73119
Phone (405) 680-2270

Interoperability endpoints

  • Direct secure messaging: lvad37198@direct-ehr-ssmhc.com

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220572800000",
    "number": "1124069059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 NW 63RD ST",
            "address_2": "SUITE 160",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731161921",
            "telephone_number": "405-858-0600",
            "fax_number": "405-858-0602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2129 SW 59TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731197024",
            "telephone_number": "405-685-6671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAD",
        "first_name": "LATA",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-10",
        "last_updated": "2008-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OK",
            "license": "13502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100019370A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.