NPIMap

Individual provider Active NPI

Russell Craig Click, M.D.

  • Family Medicine Physician
  • Shawnee, OK
National Provider Identifier
1144397571
Registry record updated Mar 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
24597 Issued in OK
Practice address
3204 Medical Park Dr
Shawnee, OK 74804-5014
Phone
(405) 878-6800
Fax
(405) 878-6831
NPI assigned
Nov 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 24597 OK Primary

Addresses

Primary practice location

3204 Medical Park Dr
Shawnee, OK 74804-5014

Mailing address

3204 Medical Park Dr
Shawnee, OK 74804-5014
Phone (405) 878-6800

Other identifiers 2

IdentifierTypeStateIssuer
OK400649OtherRAILROAD RETIREMENT FUND (RR MEDICARE
200101920AMedicaidOK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080718000524 OK Practitioner - Family Practice 6507939865 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Oklahoma College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Saints Medical Group, LLCGroup PAC ID 7012914898, 430 clinicians

Practice addresses (Care Compare)

2749 Progressive Dr
Edmond, OK 73034-7649
Phone (405) 772-4130

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24597OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care of Oklahoma, Inc Current Accepting new patients
Saints Medical Group, LLC Family Medicine CurrentSince Apr 1, 2024 Accepting new patients
SSM Health Care of Oklahoma, Inc. Family Medicine CurrentSince Feb 1, 2014 Accepting new patients
Saints Medical Group, LLC CurrentSince Apr 1, 2024 Accepting new patients
SSM Health Care of Oklahoma Inc CurrentSince Feb 1, 2014 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Summit Medical Center Past Accepting new patients
St Anthony Shawnee Hospital Inc Past Accepting new patients

Locations

7106 Solutions Ctr
Chicago, IL 60677

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

1102 W MacArthur St
Shawnee, OK 74804
Phone (405) 273-2270

3204 Medical Park Dr
Ste 104
Shawnee, OK 74804

3315 Kethley Rd
Shawnee, OK 74804
Phone (405) 273-5801

3204 Medical Park Dr
Shawnee, OK 74804
Phone (405) 214-3501

Interoperability endpoints

  • Direct secure messaging: rclick165174@direct-ehr-ssmhc.com

Organizations & group practices 8

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.

Hospital & facility affiliations 9

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

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269475200000",
    "number": "1144397571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3204 MEDICAL PARK DR",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748045014",
            "telephone_number": "405-878-6800",
            "fax_number": "405-878-6831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3204 MEDICAL PARK DR",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748045014",
            "telephone_number": "405-878-6800",
            "fax_number": "405-878-6831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLICK",
        "first_name": "RUSSELL",
        "middle_name": "CRAIG",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2010-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "24597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD RETIREMENT FUND   (RR MEDICARE",
            "identifier": "OK400649",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200101920A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee, OK

Sources for this page

Verify at the official NPI Registry.