NPIMap

Organization Active NPI

Saints Medical Group, LLC

Doing business as Saints Dermatology Center of Excellence Mustang

  • Dermatology Physician
  • Mustang, OK
National Provider Identifier
1285138032
Registry record updated Mar 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
SAINTS MEDICAL GROUP, LLC
Doing business as
Saints Dermatology Center of Excellence Mustang
Practice address
1440 N Mustang Road
Mustang, OK 73064-7214
Phone
(405) 280-7546
Fax
(405) 772-8674
NPI assigned
Mar 19, 2018
Last updated
Mar 19, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2018

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

Authorized official

Name
Crystal L Pena
Title
Insurance Credentialing Specialist
Phone
(405) 272-7452

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X OK Primary

Addresses

Primary practice location

1440 N Mustang Road
Mustang, OK 73064-7214

Mailing address

1440 N Mustang Road
Mustang, OK 73064-7214
Phone (405) 280-7546

Other names 1

  • Saints Dermatology Center of Excellence Mustang Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D2138538Saints Dermatology - Mustang1440 N Mustang Road, Mustang, OK 73064Provider-performed microscopyOct 18, 2027

National Provider Directory

National Provider Directory
Tax ID family
Saint Medical Group LLC114 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

1440 N Mustang Rd
Mustang, OK 73064
Phone (405) 280-7546

NPI Registry JSON

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

{
    "created_epoch": "1521417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521417600000",
    "number": "1285138032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 N MUSTANG ROAD",
            "city": "MUSTANG",
            "state": "OK",
            "postal_code": "730647214",
            "telephone_number": "405-280-7546",
            "fax_number": "405-772-8674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 N MUSTANG ROAD",
            "city": "MUSTANG",
            "state": "OK",
            "postal_code": "730647214",
            "telephone_number": "405-280-7546",
            "fax_number": "405-772-8674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINTS MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-19",
        "last_updated": "2018-03-19",
        "status": "A",
        "authorized_official_last_name": "PENA",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "INSURANCE CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "405-272-7452"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Saints Dermatology Center of Excellence Mustang",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Saints Dermatology Center of Excellence Mustang",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mustang, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.

Verify at the official NPI Registry.