NPIMap

Organization Active NPI

St John Sapulpa

Doing business as Family Medical Clinic

  • Family Medicine Physician
  • Sapulpa, OK
National Provider Identifier
1225284771
Registry record updated Aug 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2310 Issued in OK
Legal business name
ST JOHN SAPULPA
Doing business as
Family Medical Clinic
Practice address
1004 E Bryan
Sapulpa, OK 74066-1368
Phone
(918) 224-4280
Fax
(918) 224-6290
NPI assigned
Aug 15, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2008

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

Authorized official

Name
Mrs. Donna Sue Nagel
Title
Director of Operations
Phone
(918) 224-4280

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 2310 OK Primary

Addresses

Primary practice location

1004 E Bryan
Sapulpa, OK 74066-1368

Mailing address

1004 E Bryan
Sapulpa, OK 74066-1368
Phone (918) 224-4280

Other names 1

  • Family Medical Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Bruce C Stoesser MD Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1218758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219104000000",
    "number": "1225284771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 E BRYAN",
            "city": "SAPULPA",
            "state": "OK",
            "postal_code": "740661368",
            "telephone_number": "918-224-4280",
            "fax_number": "918-224-6290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 E BRYAN",
            "city": "SAPULPA",
            "state": "OK",
            "postal_code": "740661368",
            "telephone_number": "918-224-4280",
            "fax_number": "918-224-6290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JOHN SAPULPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-15",
        "last_updated": "2008-08-19",
        "status": "A",
        "authorized_official_last_name": "NAGEL",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "918-224-4280",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "2310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sapulpa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2008; 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.