Individual provider Active NPI

Summer Anne Fillmore, D.O.

  • Family Medicine Physician
  • Bixby, OK
National Provider Identifier
1154597086
Registry record updated Sep 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M8650 Issued in TX
Practice address
11911 S Memorial Dr
Bixby, OK 74008-2030
Phone
(918) 369-3200
Fax
(918) 369-3205
NPI assigned
Apr 30, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2015

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 M8650 TX Primary

Addresses

Primary practice location

11911 S Memorial Dr
Bixby, OK 74008-2030

Mailing address

6600 S Yale Ave
Suite 1400
Tulsa, OK 74136-3347

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
I20120110000591 OK Practitioner - Family Practice 8527123322 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Oklahoma State University College of Osteopathic Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Warren Clinic IncGroup PAC ID 8820900293, 787 clinicians

Practice addresses (Care Compare)

6600 S Yale Ave
Suite 1400
Tulsa, OK 74136-3331
Phone (918) 488-6000

Hospital & facility affiliations

  • Saint Francis Home Health Home health agency, Tulsa, OK, CCN 377107
  • Saint Francis Hospital, Inc Hospital, Tulsa, OK, CCN 370091
  • Saint Francis Hospital South, LLC Hospital, Tulsa, OK, CCN 370218
  • Saint Francis Hospital Muskogee Hospital, Muskogee, OK, CCN 370025

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M8650TXMDFamily Medicine Physician
4996OKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Warren Clinic Inc CurrentSince Dec 1, 2011 Accepting new patients

Locations

6600 S Yale Ave
Ste 1200
Tulsa, OK 74136
Phone (918) 488-6045

10506 S Memorial Dr
Tulsa, OK 74133
Phone (918) 369-3200

6600 S Yale Ave
Ste 1400
Tulsa, OK 74136
Phone (888) 247-0125

Interoperability endpoints

  • Direct secure messaging: sfillmore7662@direct.saintfrancis.com

Organizations & group practices 1

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 5

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": "1209513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442361600000",
    "number": "1154597086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 S YALE AVE",
            "address_2": "SUITE 1400",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11911 S MEMORIAL DR",
            "city": "BIXBY",
            "state": "OK",
            "postal_code": "740082030",
            "telephone_number": "918-369-3200",
            "fax_number": "918-369-3205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FILLMORE",
        "first_name": "SUMMER",
        "middle_name": "ANNE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-30",
        "last_updated": "2015-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "M8650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bixby, OK

Sources for this page

Verify at the official NPI Registry.