Organization Active NPI

Psychiatric Associates Inc

  • Psychiatry Physician
  • Oklahoma City, OK
National Provider Identifier
1205893674
Registry record updated Jul 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
PSYCHIATRIC ASSOCIATES INC
Practice address
6406 N Santa Fe Ave Ste a
Oklahoma City, OK 73116-9117
Phone
(405) 840-3793
Fax
(405) 840-3794
NPI assigned
Apr 28, 2006
Last updated
Jul 15, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2022

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

Authorized official

Name
Fay Mitchell
Title
Office Manager
Phone
(405) 840-3793

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X Primary

Addresses

Primary practice location

6406 N Santa Fe Ave Ste a
Oklahoma City, OK 73116-9117

Mailing address

6406 N Santa Fe Ave Ste a
Oklahoma City, OK 73116-9117
Phone (405) 840-3793

Other identifiers 1

IdentifierTypeStateIssuer
100740060AMedicaidOK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040126000426 OK Part B Supplier - Clinic/Group Practice 2264334671 Receives reassigned benefits from 2 practitioners
Practice locations: Oklahoma City, OK

National Provider Directory

National Provider Directory

Locations

13833 Technology Dr
#A
Oklahoma City, OK 73134
Phone (405) 840-3793

6406 N Santa Fe Ave
Ste A
Oklahoma City, OK 73116
Phone (405) 840-3793

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657843200000",
    "number": "1205893674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6406 N SANTA FE AVE STE A",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731169117",
            "telephone_number": "405-840-3793",
            "fax_number": "405-840-3794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6406 N SANTA FE AVE STE A",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731169117",
            "telephone_number": "405-840-3793",
            "fax_number": "405-840-3794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHIATRIC ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-28",
        "last_updated": "2022-07-15",
        "certification_date": "2022-07-15",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "FAY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "405-840-3793"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100740060A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.