Individual provider Active NPI

Lenard B Phillips, DO

  • Family Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1225017270
Registry record updated Dec 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
3813 Issued in OK
Practice address
11601 S Western Ave
Oklahoma City, OK 73170-5823
Phone
(405) 691-5208
Fax
(405) 378-0556
NPI assigned
Jan 10, 2006
Last updated
Dec 10, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 3813 OK Primary

Addresses

Primary practice location

11601 S Western Ave
Oklahoma City, OK 73170-5823

Mailing address

11601 S Western Ave
Oklahoma City, OK 73170-5823
Phone (405) 691-5208

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
I20031111000194 OK Practitioner - Family PracticePractitioner - Preventive MedicinePractitioner - Other (Physician) 6709799208 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3813OKMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Resource Management, LLC Family Medicine CurrentSince May 30, 2010 Accepting new patients
Medok Mustang, LLC Family Medicine CurrentSince Jun 1, 2016 Accepting new patients
Oca Stillwater LP Family Medicine Past Accepting new patients
Oca Norman, LP Family Medicine Past Accepting new patients
Oklahoma Clinical Associates LLC Family Medicine Past Accepting new patients
Rock Creek Clinic, LP Family Medicine Past Accepting new patients
Oca MWC LP Family Medicine Past Accepting new patients
Oca Tricity LP Family Medicine Past Accepting new patients
Oca 1 LLC Family Medicine Past Accepting new patients
Oca Mustang LP Family Medicine Past Accepting new patients
Oklahoma Kidney Center, Inc. Past Accepting new patients
Oca II Edmond, LLC Family Medicine PastSince Jun 1, 2010 Accepting new patients

Locations

46 E 15th St
Edmond, OK 73013
Phone (405) 691-7201

1000 NW 32nd St
Newcastle, OK 73065
Phone (405) 387-9325

334 12th Ave SE
Norman, OK 73071
Phone (405) 310-6590

334 12th Ave SE
Ste 110
Norman, OK 73071
Phone (405) 321-1911

10701 N Rockwell Ave
Oklahoma City, OK 73162
Phone (405) 470-1500

11601 S Western Ave
Oklahoma City, OK 73170
Phone (405) 512-6950

9917 SE 15th St
Oklahoma City, OK 73130
Phone (405) 622-2070

275 S Perkins Rd
Stillwater, OK 74074
Phone (405) 334-5272

2929 S Garnett Rd
Tulsa, OK 74129
Phone (918) 665-1520

1616 S Mustang Rd
Yukon, OK 73099
Phone (405) 256-0501

301 S Mustang Rd
Yukon, OK 73099
Phone (405) 324-1911

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291939200000",
    "number": "1225017270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11601 S WESTERN AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731705823",
            "telephone_number": "405-691-5208",
            "fax_number": "405-378-0556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11601 S WESTERN AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731705823",
            "telephone_number": "405-691-5208",
            "fax_number": "405-378-0556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "LENARD",
        "middle_name": "B",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2010-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "3813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.