Keto Wellness and Hormone Clinic

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

KETO WELLNESS AND HORMONE CLINIC

Practice address

900 N Porter Ave Ste 212
Norman, OK 73071-6485

Phone

(405) 217-2922

Fax

(405) 217-2940

NPI assigned

Sep 3, 2019

Last updated

Sep 3, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. John Ray Resneder, MDNPI 1316989205

Title

Owner

Phone

(405) 217-2922

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Practitioners 1

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.

• John Ray Resneder, M.D.

  • Specialist
  • Norman, OK
  • NPI 1316989205
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1567468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567468800000",
    "number": "1295383289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 N PORTER AVE STE 212",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730716485",
            "telephone_number": "405-217-2922",
            "fax_number": "405-217-2940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N PORTER AVE STE 212",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730716485",
            "telephone_number": "405-217-2922",
            "fax_number": "405-217-2940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KETO WELLNESS AND HORMONE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-03",
        "last_updated": "2019-09-03",
        "status": "A",
        "authorized_official_last_name": "RESNEDER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-217-2922",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316989205",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "john@johnresnedermd.com",
            "affiliation": "N",
            "address_1": "900 N Porter Ave Ste 212",
            "city": "Norman",
            "state": "OK",
            "country_code": "US",
            "postal_code": "730716485",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jason Nathaniel Kerns, RN
• Mishell J Kerr, APRN-CNP
• Tiffany Kersey-Williams
• Colton Gale Kesler, PHYSICIAN ASSISTANT
• Brett Ketner
• Sarah Jean Keyes
• KFG Counseling LLC
• Amer Y. Khan, M.D.
• Awaad Khan, M.D.
• Masub Khan, MD

• Specialist in Norman, OK
• Providers in Norman, OK by specialty
• Specialist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2019; 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.