Newman Physicians' Group, Inc.
Organization Active NPI Family Medicine Physician · Shattuck, OK
NPI 1316054232 · NPPES record last updated Sep 28, 2012
Key facts
- NPI
- 1316054232
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- NEWMAN PHYSICIANS' GROUP, INC.
- Practice address
- 905 S Main St
Shattuck, OK 73858-9205 - Phone
- (580) 938-5275
- Fax
- (580) 938-2256
- NPI assigned
- Aug 24, 2006
- Organization subpart
- No
Authorized official
- Name
- Franny M Laubhan
- Title
- Clinic Manager
- Phone
- (580) 938-5276
Practitioners 4
-
Richard Phillip Berry, M.D.
-
Gary A. Frederick, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060918000485 | OK | Part B Supplier - Clinic/Group Practice | 4880699297 |
Receives reassigned benefits from 1 practitioner Practice locations: Shattuck, OK |
National Provider Directory
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/FEDDBA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
905 S Main St
Shattuck, OK 73858-9205
Mailing address
PO Box 703
Shattuck, OK 73858-0703
Phone (580) 938-5275
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100730710A | Medicaid | OK |
Other providers in Shattuck, OK
- Newman Memorial Hospital, Inc
- Newman Memorial Hospital, Inc
- Newman Memorial Hospital, Inc.
- Newman Memorial Hospital, Inc.
- Newman Memorial Hospital, Inc.
- Lisa Marie Oakley
- Jerson Penaflor
- Scott Eye Care P L L C
- Shattuck Dentistry & Braces
- Shattuck Nursing Center Inc
All providers in Shattuck, OK · Family Medicine Physician in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 28, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.