NPIMap

Individual provider Active NPI

Charles Blake Stanfield, MD

  • Family Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1225091366
Registry record updated Oct 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
23951 Issued in OK
Practice address
5720 W Memorial Rd
Oklahoma City, OK 73142-2010
Phone
(405) 470-7100
Fax
(405) 470-7111
NPI assigned
Apr 10, 2006
Last updated
Oct 5, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2018

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 23951 OK Primary

Addresses

Primary practice location

5720 W Memorial Rd
Oklahoma City, OK 73142-2010

Mailing address

5300 N Independence Ave Ste 280
Oklahoma City, OK 73112-5555
Phone (405) 470-7100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050426001421 OK Practitioner - Family Practice 0547234262 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Oklahoma College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integris Ambulatory Care CorporationGroup PAC ID 2365408465, 687 clinicians

Practice addresses (Care Compare)

11101 Hefner Pointe Dr
Suite 105
Oklahoma City, OK 73120-5054
Phone (405) 751-5555

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions29
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Trail Creek Wellness PC Family Medicine CurrentSince Jan 7, 2020 Accepting new patients
Integris Ambulatory Care Corporation Family Medicine CurrentSince Oct 1, 2018 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Integris Ambulatory Care C Orporation Family Medicine Past Accepting new patients
Summit Medical Center Past Accepting new patients
Norman Minor Emergency of NRH Family Medicine Past Accepting new patients

Locations

1001 Hospital Cir
Kingfisher, OK 73750
Phone (405) 368-5460

11101 Hefner Pointe Dr
Ste 105
Oklahoma City, OK 73120
Phone (405) 604-4936

3400 NW Expressway
Ste 500
Oklahoma City, OK 73112
Phone (405) 945-4589

5300 N Independence Ave
Ste 280
Oklahoma City, OK 73112
Phone (405) 552-0155

5720 W Memorial Rd
Oklahoma City, OK 73142
Phone (405) 470-2207

Interoperability endpoints

  • Direct secure messaging: bstanfield161251@direct.integrisok.com

Organizations & group practices 6

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.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538697600000",
    "number": "1225091366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 N INDEPENDENCE AVE STE 280",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731125555",
            "telephone_number": "405-470-7100",
            "fax_number": "405-470-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5720 W MEMORIAL RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731422010",
            "telephone_number": "405-470-7100",
            "fax_number": "405-470-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANFIELD",
        "first_name": "CHARLES",
        "middle_name": "BLAKE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2018-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "23951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.