Active NPI
John Dale Grizzle II, M.D.
- Family Medicine Physician
- Oklahoma City, OK
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 20170
- Practice address
- 15800 S Western Ave
Oklahoma City, OK 73170-9393 - Phone
- (405) 793-1300
- Fax
- (405) 805-6611
- NPI assigned
- Apr 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 20170 | OK | Primary |
| Emergency Medicine Physician | 207P00000X | 20170 | OK | |
| Addiction Medicine (Family Medicine) Physician | 207QA0401X | 20170 | OK |
Addresses
Primary practice location
15800 S Western Ave
Oklahoma City, OK 73170-9393
Mailing address
15800 S Western Ave
Oklahoma City, OK 73170-9393
Phone (405) 793-1300
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 731381689GRI | Other | OK | PREMIERE |
| 080136148 | Other | OK | RAILROAD |
| 100113130C | Medicaid | OK | |
| 244431002 | Other | OK | MEDICARE ID |
| 20170 | Other | OK | LICENSE |
| 25263 | Other | OK | OBNDD |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
15800 S Western Ave
Oklahoma City, OK 73170-9393
Phone (405) 793-1300
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20170 | OK | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Hospital Kingfisher, Inc | Current | Accepting new patients | |
| Consulting Medical, PLLC | Family Medicine | Current | Accepting new patients |
| Oklahoma Emergency Physician Partners PLLC | Emergency Medicine | Current | Accepting new patients |
| Mercy Hospital Logan County Inc | Current | Accepting new patients | |
| Summit Medical Center | Past | Accepting new patients |
Locations
1800 W University Blvd
Durant, OK 74701
Phone (580) 924-3080
200 S Academy Rd
Guthrie, OK 73044
Phone (405) 260-4165
1000 Hospital Dr
Kingfisher, OK 73750
Phone (405) 375-3141
15800 S Western Ave
#A
Oklahoma City, OK 73170
4300 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 752-3962
13654 S Western Ave
Oklahoma City, OK 73170
Phone (405) 692-7756
15800 S Western Ave
Oklahoma City, OK 73170
Phone (405) 793-1300
520 S Mustang Rd
Ste V
Yukon, OK 73099
Phone (405) 936-5905
Interoperability endpoints
- jgrizzle995@directa.mercy.net
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Oklahoma City, OK
- NPI 1184269706
-
- Diagnostic Radiology Physician
- Kingfisher, OK
- NPI 1285064618
-
- Critical Access Hospital
- Guthrie, OK
- NPI 1306126818
-
- Emergency Medicine Physician
- Durant, OK
- NPI 1891039764
-
- General Acute Care Hospital
- Edmond, OK
- NPI 1356574560
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Oklahoma City, OK
- NPI 1174651558
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1760486400000",
"number": "1255396073",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15800 S WESTERN AVE",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731709393",
"telephone_number": "405-793-1300",
"fax_number": "405-805-6611"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15800 S WESTERN AVE",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731709393",
"telephone_number": "405-793-1300",
"fax_number": "405-805-6611"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIZZLE",
"first_name": "JOHN",
"middle_name": "DALE",
"name_suffix": "II",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-18",
"last_updated": "2025-10-15",
"certification_date": "2025-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OK",
"license": "20170",
"primary": true
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "OK",
"license": "20170",
"primary": false
},
{
"code": "207QA0401X",
"taxonomy_group": "",
"desc": "Family Medicine, Addiction Medicine",
"state": "OK",
"license": "20170",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREMIERE",
"identifier": "731381689GRI",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD",
"identifier": "080136148",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100113130C",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE ID",
"identifier": "244431002",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "20170",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OBNDD",
"identifier": "25263",
"state": "OK"
}
],
"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 Oct 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.