NPIMap

Organization Active NPI

Kay County Clinic Company LLC

  • Family Medicine Physician
  • Ponca City, OK
National Provider Identifier
1225072796
Registry record updated Aug 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
KAY COUNTY CLINIC COMPANY LLC
Practice address
1900 N 14TH St
Ponca City, OK 74601-2035
Phone
(580) 765-3321
Fax
(580) 765-0341
NPI assigned
Jun 15, 2006
Last updated
Aug 2, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2021

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

Authorized official

Name
Brian A Peoples
Title
VP, Physician Operations
Phone
(615) 465-7585

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NU
Family Medicine Physician 207Q00000X NU Primary
Cardiovascular Disease Physician 207RC0000X NU
Orthopaedic Surgery Physician 207X00000X NU
Family Nurse Practitioner 363LF0000X NU
Certified Registered Nurse Anesthetist 367500000X NU

Addresses

Primary practice location

1900 N 14TH St
Ponca City, OK 74601-2035

Mailing address

PO Box 689022
Franklin, TN 37068-9022
Phone (615) 465-7000

Other identifiers 1

IdentifierTypeStateIssuer
200092160AMedicaidOK

National Provider Directory

National Provider Directory

Locations

1715 N 5th St
Ponca City, OK 74601
Phone (580) 762-9292

1908 N 14th St
Ste 203
Ponca City, OK 74601
Phone (580) 718-2951

415 Fairview Ave
#202202
Ponca City, OK 74601
Phone (580) 718-4500

421 E Hartford Ave
#T
Ponca City, OK 74601
Phone (580) 762-9355

Practitioners & affiliated clinicians

Practitioners 32

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 32

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627862400000",
    "number": "1225072796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 689022",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370689022",
            "telephone_number": "615-465-7000",
            "fax_number": "615-465-3007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 N 14TH ST",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746012035",
            "telephone_number": "580-765-3321",
            "fax_number": "580-765-0341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAY COUNTY CLINIC COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-15",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A",
        "authorized_official_last_name": "PEOPLES",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VP, PHYSICIAN OPERATIONS",
        "authorized_official_telephone_number": "615-465-7585"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200092160A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponca City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2021; 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.