Juan Ruben Villazon, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

17566 Issued in OK

Practice address

219 E Commerce St
Altus, OK 73521-3913

Phone

(580) 481-2325

Fax

(580) 482-0091

NPI assigned

Aug 19, 2005

Last updated

Dec 17, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

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.

• Altus Neurology P C

  • Neurology Physician
  • Altus, OK
  • NPI 1780721779
  Authorized official Same address or phone
• C L Soo MD PC

  • Orthopaedic Surgery of the Spine Physician
  • Oklahoma City, OK
  • NPI 1588983100
  NPD (past)
• Jackson County Memorial Hospital Authority

  • General Acute Care Hospital
  • Altus, OK
  • NPI 1093763781
  NPD (past)
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355702400000",
    "number": "1174515605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1137",
            "city": "ALTUS",
            "state": "OK",
            "postal_code": "735221137",
            "telephone_number": "580-481-2325",
            "fax_number": "580-482-0091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 E COMMERCE ST",
            "city": "ALTUS",
            "state": "OK",
            "postal_code": "735213913",
            "telephone_number": "580-481-2325",
            "fax_number": "580-482-0091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLAZON",
        "first_name": "JUAN",
        "middle_name": "RUBEN",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-19",
        "last_updated": "2012-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OK",
            "license": "17566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100021950A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rhonda E Valdez, LCSW
• Valir Outpatient Clinic #6 LLC
• Valir Outpatient Clinics LLC
• Steven C Vaughan, DPH
• Brandy Jo Vermillion, APRN-CNP
• Vision Source Altus PLLC
• Neil B Vitale, M.D.
• Renae L Vitale, MSW, LCSW
• Rebecca Merre Waechter, MA
• Wal-Mart Stores East LP (Walmart Pharmacy 10-0479)

• Specialist in Altus, OK
• Providers in Altus, OK by specialty
• Specialist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2012; 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.