Susan T Redwine, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

22619 Issued in OK

Practice address

200 N Bryant Ave
Edmond, OK 73034-6273

Phone

(405) 330-7000

NPI assigned

Feb 17, 2006

Sex

Female

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 3

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Ou Health Partners, Inc

  dba Ou Health Partners

  • Multi-Specialty Clinic/Center
  • Oklahoma City, OK
  • NPI 1528642642
  Medicare reassignment NPD
• Ou Health Partners, Inc

  dba OUHP Orthotics & Prosthetic

  • Prosthetic/Orthotic Supplier
  • Oklahoma City, OK
  • NPI 1447834460
  NPD
• Chickasaw Nation Division of Health

  dba Chickasaw Nation Tishomingo Clinic

  • Primary Care Clinic/Center
  • Tishomingo, OK
  • NPI 1649330242
  NPD (past)
• National Family Medical Associates, LLC

  dba VIPcare

  • Primary Care Clinic/Center
  • Tulsa, OK
  • NPI 1477287720
  NPD (past)
• Ou Medicine Inc.

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

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280880000000",
    "number": "1144295775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N BRYANT AVE",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730346273",
            "telephone_number": "406-330-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N BRYANT AVE",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730346273",
            "telephone_number": "405-330-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDWINE",
        "first_name": "SUSAN",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-17",
        "last_updated": "2010-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OK",
            "license": "22619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200066430A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "22619",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OBNDD",
            "identifier": "30634",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Recovery Achievements LLC
• Red River RX Solutions, LLC (Red River Rx Solutions)
• Redbud Dental Edmond, PLLC
• Redeemed Counseling PLLC
• Ralph L Redline III, PT
• Charmetra Reece
• Dwight Reece Jr.
• Dwight Reece II
• Reed Counseling Services PLLC
• Brianne Noelle Reed, LMFT, LADC

• Pediatrics Physician in Edmond, OK
• Providers in Edmond, OK by specialty
• Pediatrics Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.