NPIMap

Organization Active NPI

McCurtain Memorial Medical Management, Inc

  • Family Nurse Practitioner
  • Idabel, OK
National Provider Identifier
1255583142
Registry record updated Jan 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
MCCURTAIN MEMORIAL MEDICAL MANAGEMENT, INC
Practice address
1425 E Lincoln Rd
Suite B-2
Idabel, OK 74745-7345
Phone
(580) 286-4304
Fax
(580) 286-4305
NPI assigned
Oct 22, 2008
Organization subpart
Yes
Parent organization
MCCURTAIN MEMORIAL MEDICAL MANAGEMENT, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 21, 2009

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

Authorized official

Name
Mr. Ray B Whitmore Jr.
Title
Chief Financial Officer
Phone
(580) 208-3104

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

1425 E Lincoln Rd
Suite B-2
Idabel, OK 74745-7345

Mailing address

1301 E Lincoln Rd
Idabel, OK 74745-7300
Phone (580) 208-3104

Other names 1

  • MedFast Walk In Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
McCurtain Memorial HSP16 organizations share this tax ID, including this one
Part of
McCurtain Memorial HSP

Other organizations with this tax ID 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1224633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232496000000",
    "number": "1255583142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 E LINCOLN RD",
            "city": "IDABEL",
            "state": "OK",
            "postal_code": "747457300",
            "telephone_number": "580-208-3104",
            "fax_number": "580-208-3199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 E LINCOLN RD",
            "address_2": "SUITE B-2",
            "city": "IDABEL",
            "state": "OK",
            "postal_code": "747457345",
            "telephone_number": "580-286-4304",
            "fax_number": "580-286-4305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCCURTAIN MEMORIAL MEDICAL MANAGEMENT, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MCCURTAIN MEMORIAL MEDICAL MANAGEMENT, INC",
        "enumeration_date": "2008-10-22",
        "last_updated": "2009-01-21",
        "status": "A",
        "authorized_official_last_name": "WHITMORE",
        "authorized_official_first_name": "RAY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "580-208-3104",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MedFast Walk In Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Idabel, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2009; 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.