NPIMap

Organization Active NPI

Premier Physician Staffing 2 PLLC

  • Emergency Medicine Physician
  • McAlester, OK
National Provider Identifier
1326509407
Registry record updated Mar 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
PREMIER PHYSICIAN STAFFING 2 PLLC
Practice address
1 E Clark Bass Blvd
McAlester, OK 74501-4209
Phone
(918) 543-5150
NPI assigned
Mar 29, 2019
Last updated
Mar 29, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2019

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

Authorized official

Name
Dr. Matthew Jenkins, DONPI 1437457009
Title
Owner/Manager
Phone
(918) 543-5150

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
Emergency Medicine Physician 207P00000X Primary

Addresses

Primary practice location

1 E Clark Bass Blvd
McAlester, OK 74501-4209

Mailing address

20 E 5TH St Ste 620
Tulsa, OK 74103-4441
Phone (918) 543-5150

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190513000686 OK Part B Supplier - Clinic/Group Practice 3375886476 Receives reassigned benefits from 58 practitioners
Practice locations: McAlester, OK

National Provider Directory

National Provider Directory

Locations

20 E 5th St
Ste 620
Tulsa, OK 74103
Phone (918) 543-5150

Practitioners & affiliated clinicians

Practitioners 59

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.

View all 59

NPI Registry JSON

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

{
    "created_epoch": "1553817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553817600000",
    "number": "1326509407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 E 5TH ST STE 620",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741034441",
            "telephone_number": "918-543-5150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 E CLARK BASS BLVD",
            "city": "MCALESTER",
            "state": "OK",
            "postal_code": "745014209",
            "telephone_number": "918-543-5150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PHYSICIAN STAFFING 2 PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-29",
        "last_updated": "2019-03-29",
        "status": "A",
        "authorized_official_last_name": "JENKINS",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "918-543-5150",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McAlester, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 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.