Individual provider Active NPI

Keri Doneece Smith, D.O.

  • Emergency Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1245425867
Registry record updated Sep 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
4557 Issued in OK
Practice address
4401 S Western Ave
Oklahoma City, OK 73109-3413
Phone
(405) 636-7195
NPI assigned
Sep 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4557 OK Primary

Addresses

Primary practice location

4401 S Western Ave
Oklahoma City, OK 73109-3413

Mailing address

1735 Lake Shadows CT
Edmond, OK 73012-2072
Phone (405) 831-3128

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
I20080821000151 OK Practitioner - Emergency Medicine 8820163116 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4557OKMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Central Emergency Services PC Emergency Medicine CurrentSince Dec 10, 2010 Accepting new patients
Oklahoma Emergency Services PC Emergency Medicine CurrentSince Jan 1, 2012 Accepting new patients
Emergency Services of Oklahoma PC Emergency Medicine CurrentSince Jan 1, 2011 Accepting new patients
Integris South Oklahoma City Hospital Corporation Past Accepting new patients
Washita Emergency Physicians LLC Emergency Medicine Past Accepting new patients

Locations

3401 W Gore Blvd
Lawton, OK 73505
Phone (580) 483-5207

901 N Porter Ave
Norman, OK 73071
Phone (405) 307-1500

9600 Broadway Ext
Oklahoma City, OK 73114
Phone (405) 486-2100

4401 S Western Ave
Oklahoma City, OK 73109
Phone (405) 636-7000

3300 NW Expressway St
Oklahoma City, OK 73112
Phone (405) 251-2815

4050 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 608-3200

1900 N 14th St
Ponca City, OK 74601
Phone (580) 718-2932

1323 W 6th Ave
Stillwater, OK 74074
Phone (405) 372-1480

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.

NPI Registry JSON

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

{
    "created_epoch": "1189036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189036800000",
    "number": "1245425867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1735 LAKE SHADOWS CT",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730122072",
            "telephone_number": "405-831-3128",
            "fax_number": "405-713-7629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 S WESTERN AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731093413",
            "telephone_number": "405-636-7195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KERI",
        "middle_name": "DONEECE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-06",
        "last_updated": "2007-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "4557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.