NPIMap

Organization Active NPI

Great Plains Medical Foundation

Doing business as Great Plains Family Practice

  • Family Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1285708164
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GREAT PLAINS MEDICAL FOUNDATION
Doing business as
Great Plains Family Practice
Practice address
3500 NW 56TH St Ste 100
Oklahoma City, OK 73112-4517
Phone
(405) 951-2855
Fax
(405) 951-2858
NPI assigned
Nov 20, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Neal Clemenson, MD
Title
Chairman
Phone
(405) 951-2855

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

3500 NW 56TH St Ste 100
Oklahoma City, OK 73112-4517

Mailing address

3500 NW 56TH St Ste 100
Oklahoma City, OK 73112-4517
Phone (405) 951-2855

Other names 1

  • Great Plains Family Practice Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050430000033 OK Part B Supplier - Clinic/Group Practice 9335188184 Receives reassigned benefits from 18 practitioners
Practice locations: Oklahoma City, OK

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

3500 NW 56th St
Ste 100
Oklahoma City, OK 73112
Phone (405) 951-2855

Practitioners & affiliated clinicians

Practitioners 36

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285708164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 NW 56TH ST STE 100",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124517",
            "telephone_number": "405-951-2855",
            "fax_number": "405-951-2858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 NW 56TH ST STE 100",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124517",
            "telephone_number": "405-951-2855",
            "fax_number": "405-951-2858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT PLAINS MEDICAL FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CLEMENSON",
        "authorized_official_first_name": "NEAL",
        "authorized_official_title_or_position": "CHAIRMAN",
        "authorized_official_telephone_number": "405-951-2855",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Great Plains Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.