Individual provider Active NPI

Taylor Craft, D.O.

  • Pediatrics Physician
  • Oklahoma City, OK
National Provider Identifier
1235678863
Registry record updated Jun 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
6386 Issued in OK
Practice address
3400 S Douglas Blvd Ste 307
Oklahoma City, OK 73150-1001
Phone
(405) 772-4620
Fax
(405) 772-4623
NPI assigned
Feb 15, 2017
Last updated
Jun 24, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Pediatrics Physician 208000000X 6386 OK Primary

Addresses

Primary practice location

3400 S Douglas Blvd Ste 307
Oklahoma City, OK 73150-1001

Mailing address

3400 S Douglas Blvd Ste 307
Oklahoma City, OK 73150-1001
Phone (405) 772-4620

Other practice location 1

717 S Houston Ave
Tulsa, OK 74127-9023
Phone (918) 382-3178

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
I20200708000244 OK Practitioner - Pediatric Medicine 1153744214 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6386OKMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saints Medical Group, LLC Pediatrics CurrentSince Jul 15, 2020 Accepting new patients
Saints Medical Group, LLC CurrentSince Jul 15, 2020 Accepting new patients
Summit Medical Center Past Accepting new patients
SSM Health Care of Oklahoma, Inc. Past Accepting new patients

Locations

1800 S Douglas Blvd
Oklahoma City, OK 73130
Phone (405) 732-7119

3400 S Douglas Blvd
Ste 307
Oklahoma City, OK 73150
Phone (405) 218-2582

608 NW 9th St
Ste 2200
Oklahoma City, OK 73102
Phone (405) 231-3737

777 NW 63rd St
Fl 4
Oklahoma City, OK 73116
Phone (405) 231-3818

3315 Kethley Rd
Shawnee, OK 74804
Phone (405) 273-5801

Interoperability endpoints

  • Direct secure messaging: tcraft376005@direct-ehr-ssmhc.com

Organizations & group practices 4

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": "1487116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1235678863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 S DOUGLAS BLVD STE 307",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731501001",
            "telephone_number": "405-772-4620",
            "fax_number": "405-772-4623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 S DOUGLAS BLVD STE 307",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731501001",
            "telephone_number": "405-772-4620",
            "fax_number": "405-772-4623"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "717 S Houston Ave",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741279023",
            "country_code": "US",
            "telephone_number": "918-382-3178",
            "fax_number": "918-382-6789",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRAFT",
        "first_name": "TAYLOR",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-15",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OK",
            "license": "6386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.