Mark Damon II, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

04752 Issued in OK

Practice address

1011 14TH Ave NW
Ardmore, OK 73401-1828

Phone

(580) 220-6658

Fax

(580) 220-6673

NPI assigned

Jul 1, 2009

Last updated

Apr 28, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK, FL2 enrollments

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 2

Specialty

Emergency Medicine

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lake Wales Emergency Physicians, LLCGroup PAC ID 8022270461, 36 clinicians

Ridgewood Emergency Group, LLCGroup PAC ID 6305199597, 43 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Heart of Florida Hospital, Davenport, FL, CCN 100137
• Adventhealth Lake Wales Hospital, Lake Wales, FL, CCN 100099

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mdamon48473@direct-ehr-ssmhc.com

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.

• Lake Wales Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Lake Wales, FL
  • NPI 1033480405
  Medicare reassignment Care Compare group NPD
• Ridgewood Emergency Group, LLC

  • Emergency Medicine Physician
  • Davenport, FL
  • NPI 1750862694
  Medicare reassignment Care Compare group NPD
• Emergency Physicians of Mid-America, P.C.

  • Emergency Medicine Physician
  • Oklahoma City, OK
  • NPI 1063825297
  Medicare reassignment NPD
• Emergency Physicians of Midwest City, LLC

  • Emergency Medicine Physician
  • Oklahoma City, OK
  • NPI 1558386474
  Medicare reassignment NPD
• Emergency Services of Oklahoma PC

  • Emergency Medicine Physician
  • Norman, OK
  • NPI 1215249891
  Medicare reassignment NPD
• Mercy Hospital Logan County Inc

  • Critical Access Hospital
  • Guthrie, OK
  • NPI 1306126818
  Medicare reassignment NPD
• Oklahoma Emergency Services PC

  • Emergency Medicine Physician
  • Lawton, OK
  • NPI 1114239795
  Medicare reassignment NPD
• Ou Health Partners, Inc

  dba Ou Health Partners

  • Multi-Specialty Clinic/Center
  • Oklahoma City, OK
  • NPI 1528642642
  Medicare reassignment NPD
• South Central Emergency Services PC

  • Emergency Medicine Physician
  • Stillwater, OK
  • NPI 1558663724
  Medicare reassignment NPD
• Ou Health Partners, Inc

  dba OUHP Orthotics & Prosthetic

  • Prosthetic/Orthotic Supplier
  • Oklahoma City, OK
  • NPI 1447834460
  NPD
• Ridgewood Emergency Group, LLC

  • Emergency Medicine Physician
  • Winter Haven, FL
  • NPI 1679324842
  NPD
• Ou Medicine Inc.

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1649794157
  NPD (past)

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

• Adventhealth Polk North Inc

  dba AdventHealth Heart of Florida

  • General Acute Care Hospital
  • Davenport, FL
  • NPI 1801457510
  Care Compare affiliation
• Adventhealth Polk South Inc

  dba AdventHealth Lake Wales

  • General Acute Care Hospital
  • Lake Wales, FL
  • NPI 1053972760
  Care Compare affiliation

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

{
    "created_epoch": "1246406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398643200000",
    "number": "1124256888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 W MEMORIAL RD",
            "address_2": "140",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731341785",
            "telephone_number": "405-762-3162",
            "fax_number": "405-396-5211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 14TH AVE NW",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734011828",
            "telephone_number": "580-220-6658",
            "fax_number": "580-220-6673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMON",
        "first_name": "MARK",
        "name_suffix": "II",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-01",
        "last_updated": "2014-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "04752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200250290A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Johanna Alene Cummings, PTA
• Mona Cunningham, LPC
• Sammie Cunningham, BHRS
• Miranda Mennika Curbow
• Cassandra Rose D'Andrea, M.D.
• Alexis Damron
• Linda Dancer
• Daniel C Harris, M.D. PC
• Cindy Daniel
• Colton Richard Danyeur, PHARM.D.

• Emergency Medicine Physician in Ardmore, OK
• Providers in Ardmore, OK by specialty
• Emergency Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.