Active NPI
Gary R. Kindell, M.D.
- Family Medicine Physician
- Stroud, OK
National Provider Identifier
1285799841
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 15655
- Practice address
- 356110 E 930 Rd
Stroud, OK 74079-5184 - Phone
- (918) 968-9531
- NPI assigned
- Dec 26, 2006
- Last updated
- Mar 7, 2023
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 15655 | OK | Primary |
| Phlebology Physician | 202K00000X | 6365 | AK |
Addresses
Primary practice location
356110 E 930 Rd
Stroud, OK 74079-5184
Mailing address
356110 E 930 Rd
Stroud, OK 74079-5184
Phone (918) 968-9531
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| K161799 | Other | AK | MEDICARE NO. |
| MD0340 | Other | AK | MEDICAID NO. |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180227002289 | TX | Order and Referring Only - Family Practice | 4284680281 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15655 | OK | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Premise Health of Oklahoma Medical PC | Past | Accepting new patients | |
| Rebecca J Daniels, MD LLC | Family Medicine | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba the Doc Powered by Premise Health
- Multi-Specialty Clinic/Center
- Oklahoma City, OK
- NPI 1902475957
-
dba Daniels Community Clinic
- Family Medicine Physician
- Stillwater, OK
- NPI 1922244912
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1285799841",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "356110 E 930 RD",
"city": "STROUD",
"state": "OK",
"postal_code": "740795184",
"telephone_number": "918-968-9531",
"fax_number": "907-631-5099"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "356110 E 930 RD",
"city": "STROUD",
"state": "OK",
"postal_code": "740795184",
"telephone_number": "918-968-9531"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KINDELL",
"first_name": "GARY",
"middle_name": "R.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-26",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OK",
"license": "15655",
"primary": true
},
{
"code": "202K00000X",
"taxonomy_group": "",
"desc": "Phlebology",
"state": "AK",
"license": "6365",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE NO.",
"identifier": "K161799",
"state": "AK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID NO.",
"identifier": "MD0340",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Stroud, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.