NPIMap

Organization Active NPI

Seminole Clinic PLLC

  • Primary Care Clinic/Center
  • Seminole, OK
National Provider Identifier
1215336193
Registry record updated Aug 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
2875 Issued in OK
Legal business name
SEMINOLE CLINIC PLLC
Doing business as
Seminole Clinic
Practice address
2403 W Wrangler Blvd
Ste a
Seminole, OK 74868-1900
Phone
(405) 382-4939
Fax
(405) 382-4947
NPI assigned
Aug 18, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2014

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

Authorized official

Name
Dr. Randall Leon Kemp, DO
Title
Sole Member
Phone
(405) 382-4939

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 2875 OK Primary

Addresses

Primary practice location

2403 W Wrangler Blvd
Ste a
Seminole, OK 74868-1900

Mailing address

2403 W Wrangler Blvd
Ste a
Seminole, OK 74868-1900
Phone (405) 382-4939

Other names 1

  • Seminole Clinic Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1408320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408320000000",
    "number": "1215336193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2403 W WRANGLER BLVD",
            "address_2": "STE A",
            "city": "SEMINOLE",
            "state": "OK",
            "postal_code": "748681900",
            "telephone_number": "405-382-4939",
            "fax_number": "405-382-4947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2403 W WRANGLER BLVD",
            "address_2": "STE A",
            "city": "SEMINOLE",
            "state": "OK",
            "postal_code": "748681900",
            "telephone_number": "405-382-4939",
            "fax_number": "405-382-4947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEMINOLE CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-18",
        "last_updated": "2014-08-18",
        "status": "A",
        "authorized_official_last_name": "KEMP",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "LEON",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "405-382-4939",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "OK",
            "license": "2875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Seminole Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Seminole, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.