NPIMap

Organization Active NPI

Medicine Wheel Inc

Doing business as Caddo Family Medicine Clinic

  • Family Medicine Physician
  • Caddo, OK
National Provider Identifier
1285978007
Registry record updated Nov 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2982 Issued in OK
Legal business name
MEDICINE WHEEL INC
Doing business as
Caddo Family Medicine Clinic
Practice address
128 Buffalo Street
Caddo, OK 74729
Phone
(580) 367-2100
Fax
(580) 367-2103
NPI assigned
Nov 16, 2012
Last updated
Nov 16, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2012

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

Authorized official

Name
Paul E Weathers, DO
Title
Medical Director
Phone
(580) 367-2100

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 2982 OK
Family Medicine Physician 207Q00000X 2982 OK Primary

Addresses

Primary practice location

128 Buffalo Street
Caddo, OK 74729

Mailing address

PO Box 146
Caddo, OK 74729-0146
Phone (580) 367-2100

Other names 1

  • Caddo Family Medicine Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Caddo Family Medicine Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1353024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353024000000",
    "number": "1285978007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 146",
            "city": "CADDO",
            "state": "OK",
            "postal_code": "747290146",
            "telephone_number": "580-367-2100",
            "fax_number": "580-367-2103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 BUFFALO STREET",
            "city": "CADDO",
            "state": "OK",
            "postal_code": "74729",
            "telephone_number": "580-367-2100",
            "fax_number": "580-367-2103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICINE WHEEL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-16",
        "last_updated": "2012-11-16",
        "status": "A",
        "authorized_official_last_name": "WEATHERS",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "580-367-2100",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "OK",
            "license": "2982",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "2982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Caddo Family Medicine Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Caddo, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.