Individual provider Active NPI

Ryan Richard Ludlow, DO

  • Family Medicine Physician
  • Durant, OK
National Provider Identifier
1164917795
Registry record updated Mar 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
6701 Issued in OK
Practice address
1600 W University Blvd
Durant, OK 74701-3094
Phone
(580) 924-5500
NPI assigned
Jun 26, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 6701 OK
Family Medicine Physician 207Q00000X 6701 OK Primary

Addresses

Primary practice location

1600 W University Blvd
Durant, OK 74701-3094

Mailing address

1600 W University Blvd
Durant, OK 74701-3094

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
I20191210000096 OK Practitioner - Emergency Medicine 9830426493 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elite Integral Staffing LLCGroup PAC ID 0648612341, 15 clinicians

Practice addresses (Care Compare)

1800 W University Blvd
Durant, OK 74701-3006
Phone (719) 688-1483

Hospital & facility affiliations

  • Alliancehealth Durant Hospital, Durant, OK, CCN 370014

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6701OKMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Oklahoma Emergency Physician Partners PLLC Emergency Medicine Current Accepting new patients
Elite Integral Staffing LLC Emergency Medicine CurrentSince Apr 1, 2024 Accepting new patients
Nes Oklahoma, Inc. Emergency Medicine CurrentSince Oct 31, 2022 Accepting new patients
Marshall County Hma, LLC Past Accepting new patients
Durant Hma LLC Past Accepting new patients

Locations

1800 W University Blvd
Durant, OK 74701
Phone (580) 924-3080

1600 W University Blvd
Durant, OK 74701
Phone (580) 740-0205

901 S 5th Ave
Madill, OK 73446
Phone (580) 564-7338

1900 N 14th St
Ponca City, OK 74601
Phone (580) 718-2932

105 Wall St
Poteau, OK 74953
Phone (918) 635-3100

Organizations & group practices 5

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 1

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": "1529971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584921600000",
    "number": "1164917795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 W UNIVERSITY BLVD",
            "city": "DURANT",
            "state": "OK",
            "postal_code": "747013094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W UNIVERSITY BLVD",
            "city": "DURANT",
            "state": "OK",
            "postal_code": "747013094",
            "telephone_number": "580-924-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUDLOW",
        "first_name": "RYAN",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-26",
        "last_updated": "2020-03-23",
        "certification_date": "2020-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "6701",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "6701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durant, OK

Sources for this page

Verify at the official NPI Registry.