Active NPI
Charles Stephen Paine Jr., M.D.
- General Practice Physician
- Cushing, OK
National Provider Identifier
1275759367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 28754
- Practice address
- 3200 S Kings Hwy
Cushing, OK 74023-5355 - Phone
- (918) 225-3336
- NPI assigned
- Apr 17, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 01036853 | IN | |
| General Practice Physician | 208D00000X | 28754 | OK | Primary |
Addresses
Primary practice location
3200 S Kings Hwy
Cushing, OK 74023-5355
Mailing address
8706 W Eseco
Agra, OK 74824-6208
Phone (918) 285-6344
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01036853 | IN | MD | Family Medicine Physician |
| 28754 | OK | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1414627200000",
"number": "1275759367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8706 W ESECO",
"city": "AGRA",
"state": "OK",
"postal_code": "748246208",
"telephone_number": "918-285-6344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3200 S KINGS HWY",
"city": "CUSHING",
"state": "OK",
"postal_code": "740235355",
"telephone_number": "918-225-3336"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAINE",
"first_name": "CHARLES",
"middle_name": "STEPHEN",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-17",
"last_updated": "2014-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "01036853",
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "OK",
"license": "28754",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cushing, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.