NPIMap

Organization Active NPI

Southwest Gastroenterology Associates PLLC

  • Gastroenterology Physician
  • Oklahoma City, OK
National Provider Identifier
1306111448
Registry record updated Aug 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
22226 Issued in OK
Legal business name
SOUTHWEST GASTROENTEROLOGY ASSOCIATES PLLC
Practice address
525 SW 80TH Street
Suite 200
Oklahoma City, OK 73139
Phone
(405) 631-0481
Fax
(405) 631-9025
NPI assigned
Mar 21, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2019

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

Authorized official

Name
Dr. Ravinder R Kurella, M.D.NPI 1154415347
Title
Owner
Phone
(405) 631-0481

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X 22226 OK Primary

Addresses

Primary practice location

525 SW 80TH Street
Suite 200
Oklahoma City, OK 73139

Mailing address

525 SW 80TH Street
Suite 200
Oklahoma City, OK 73139
Phone (405) 631-0481

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120523000040 OK Part B Supplier - Clinic/Group Practice 7416110820 Receives reassigned benefits from 1 practitioner
Practice locations: Oklahoma City, OK

National Provider Directory

National Provider Directory

Locations

8100 S Walker Ave
Ste 230
Oklahoma City, OK 73139
Phone (405) 631-0481

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1332288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566432000000",
    "number": "1306111448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 SW 80TH STREET",
            "address_2": "SUITE 200",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73139",
            "telephone_number": "405-631-0481",
            "fax_number": "405-631-9025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 SW 80TH STREET",
            "address_2": "SUITE 200",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73139",
            "telephone_number": "405-631-0481",
            "fax_number": "405-631-9025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST GASTROENTEROLOGY ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-21",
        "last_updated": "2019-08-22",
        "status": "A",
        "authorized_official_last_name": "KURELLA",
        "authorized_official_first_name": "RAVINDER",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-631-0481",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OK",
            "license": "22226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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, 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.