Organization Active NPI

Internal Medicine Clinic PLLC

  • Internal Medicine Physician
  • Guymon, OK
National Provider Identifier
1164541900
Registry record updated Dec 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
18750 Issued in OK
Legal business name
INTERNAL MEDICINE CLINIC PLLC
Practice address
410 NE 12TH Street
Guymon, OK 73942
Phone
(580) 338-5500
Fax
(580) 468-4942
NPI assigned
Mar 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2025

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

Authorized official

Name
Dr. Jeffrey J Lim, MDNPI 1972503241
Title
Member
Phone
(580) 338-5500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 18750 OK Primary

Addresses

Primary practice location

410 NE 12TH Street
Guymon, OK 73942

Mailing address

PO Box 158
410 NE 12TH Street
Guymon, OK 73942-0158
Phone (580) 338-5500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070402000292 OK Part B Supplier - Clinic/Group Practice 9436253465 Receives reassigned benefits from 1 practitioner
Practice locations: Guymon, OK

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D0958766Internal Medicine Clinic, PLLC410 NE 12TH Street, Guymon, OK 73942Certificate of waiverAug 9, 2027

National Provider Directory

National Provider Directory

Locations

410 NE 12th St
Guymon, OK 73942
Phone (580) 338-5500

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764806400000",
    "number": "1164541900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 158",
            "address_2": "410 NE 12TH STREET",
            "city": "GUYMON",
            "state": "OK",
            "postal_code": "739420158",
            "telephone_number": "580-338-5500",
            "fax_number": "580-468-4942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 NE 12TH STREET",
            "city": "GUYMON",
            "state": "OK",
            "postal_code": "73942",
            "telephone_number": "580-338-5500",
            "fax_number": "580-468-4942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A",
        "authorized_official_last_name": "LIM",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "580-338-5500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "18750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guymon, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.