NPIMap

Organization Active NPI

South Wellness Community Health Clinic

  • Community Health Clinic/Center
  • Oklahoma City, OK
National Provider Identifier
1235546961
Registry record updated May 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
SOUTH WELLNESS COMMUNITY HEALTH CLINIC
Practice address
1122 NE 13TH St
Ori 274
Oklahoma City, OK 73117-1039
Phone
(405) 271-5860
Fax
(405) 778-6843
NPI assigned
Jul 15, 2014
Organization subpart
Yes
Parent organization
BOARD OF REGENTS OF THE UNIVERSITY OF OKLAHOMA-OU PHYSICIANSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 18, 2015

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

Authorized official

Name
Brian L Maddy
Title
Ceo
Phone
(405) 271-3932

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X Primary

Addresses

Primary practice location

1122 NE 13TH St
Ori 274
Oklahoma City, OK 73117-1039

Mailing address

2149 SW 59TH St
Oklahoma City, OK 73119-7033
Phone (405) 271-5860

National Provider Directory

National Provider Directory
Tax ID family
Board of Regents of the Univ of Oklahoma-Ou Phys Orl38 organizations share this tax ID, including this one
Part of
Board of Regents of the Univ of Oklahoma-Ou Phys Orl

Other organizations with this tax ID 37

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

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1405382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431907200000",
    "number": "1235546961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2149 SW 59TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731197033",
            "telephone_number": "405-271-5860",
            "fax_number": "405-778-6843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 NE 13TH ST",
            "address_2": "ORI 274",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731171039",
            "telephone_number": "405-271-5860",
            "fax_number": "405-778-6843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH WELLNESS COMMUNITY HEALTH CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BOARD OF REGENTS OF THE UNIVERSITY OF OKLAHOMA-OU PHYSICIANS",
        "enumeration_date": "2014-07-15",
        "last_updated": "2015-05-18",
        "status": "A",
        "authorized_official_last_name": "MADDY",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "405-271-3932"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2015; 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.