NPIMap

Organization Active NPI

SSM Healthcare of Ok, Inc

  • Radiology Clinic/Center
  • Oklahoma City, OK
National Provider Identifier
1124300512
Registry record updated Sep 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
SSM HEALTHCARE OF OK, INC
Practice address
1000 N Lee Ave
4TH Floor
Oklahoma City, OK 73102-1036
Phone
(405) 272-7699
Fax
(405) 272-6662
NPI assigned
Sep 13, 2011
Organization subpart
Yes
Parent organization
SSM HEALTHCARE OF OK, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 13, 2011

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

Authorized official

Name
Ms. Crystal L Pena
Title
Insurance Credentialing Specialist
Phone
(405) 272-7452

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X Primary

Addresses

Primary practice location

1000 N Lee Ave
4TH Floor
Oklahoma City, OK 73102-1036

Mailing address

3330 NW 56TH St
Suite 206
Oklahoma City, OK 73112-4479
Phone (405) 945-4760

Other names 1

  • St Anthony Interventional Radiology Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Marilyn Doughtery MD56 organizations share this tax ID, including this one
Part of
Marilyn Doughtery MD

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1315872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315872000000",
    "number": "1124300512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3330 NW 56TH ST",
            "address_2": "SUITE 206",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124479",
            "telephone_number": "405-945-4760",
            "fax_number": "405-562-9242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N LEE AVE",
            "address_2": "4TH FLOOR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731021036",
            "telephone_number": "405-272-7699",
            "fax_number": "405-272-6662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SSM HEALTHCARE OF OK, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SSM HEALTHCARE OF OK, INC",
        "enumeration_date": "2011-09-13",
        "last_updated": "2011-09-13",
        "status": "A",
        "authorized_official_last_name": "PENA",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "INSURANCE CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "405-272-7452",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Anthony Interventional Radiology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.