Individual provider Active NPI

Gary R. Kindell, M.D.

  • Family Medicine Physician
  • Stroud, OK
National Provider Identifier
1285799841
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
15655 Issued in OK
Practice address
356110 E 930 Rd
Stroud, OK 74079-5184
Phone
(918) 968-9531
NPI assigned
Dec 26, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
K161799OtherAKMEDICARE NO.
MD0340OtherAKMEDICAID 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180227002289 TX Order and Referring Only - Family PracticePractitioner - 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. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
15655OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew 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.

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

Verify at the official NPI Registry.