Keith Stacy Patterson, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4322 Issued in OK

Practice address

10512 North 110TH East Avenue
Owasso, OK 74055-6636

Phone

(918) 376-8900

Fax

(918) 272-7475

NPI assigned

Aug 1, 2006

Last updated

May 6, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OK

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

Specialty

Family Practice

Education

Oklahoma State University College of Osteopathic Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ahs Oklahoma Physician Group LLCGroup PAC ID 9436122496, 314 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bailey Medical Center, LLC Hospital, Owasso, OK, CCN 370228
• Hillcrest Medical Center Hospital, Tulsa, OK, CCN 370001

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4
• Direct secure messaging: kpatterson112890@ahs.direct-ci.com

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.

• Ahs Oklahoma Physician Group LLC

  dba Utica Park Clinic

  • Family Medicine Physician
  • Tulsa, OK
  • NPI 1235182775
  Medicare reassignment Care Compare group NPD
• Ahs Oklahoma Physician Group, LLC

  dba Cushing Medical Specialist

  • Rural Health Clinic/Center
  • Cushing, OK
  • NPI 1922683051
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ahs Hillcrest Medical Center, LLC

  dba Hillcrest Medical Center

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1629057229
  Care Compare affiliation
• Bailey Medical Center, LLC

  • General Acute Care Hospital
  • Owasso, OK
  • NPI 1205846037
  Care Compare affiliation

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399334400000",
    "number": "1306853874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10512 N 110TH EAST AVE",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740556636",
            "telephone_number": "918-376-8900",
            "fax_number": "918-376-8990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10512 NORTH 110TH EAST AVENUE",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740556636",
            "telephone_number": "918-376-8900",
            "fax_number": "918-272-7475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "KEITH",
        "middle_name": "STACY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2014-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "4322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200091850A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "4322",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephan Owings
• Pacific Physician Services LLC
• Palliative Connections of Oklahoma Inc
• Nicole Paoli Morales
• Amanda Partridge, P.A.-C
• Paul a Cook MD PLLC
• Paula Bonebrake, LPC
• Sara Paulson
• Phyllis A. Peace, APRN
• Peak Wellness, Inc. (Peak Wellness)

• Family Medicine Physician in Owasso, OK
• Providers in Owasso, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2014; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.