Okmulgee Pediatrics PC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

OKMULGEE PEDIATRICS PC

Doing business as

Okmulgee Pediatrics & Family Care, L.L.P.

Practice address

916 E 8TH St
Okmulgee, OK 74447-4724

Phone

(918) 756-8371

Fax

(918) 758-3437

NPI assigned

Oct 19, 2006

Organization subpart

No

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

Authorized official

Name

Karen Renee Wilson

Title

Office Manager

Phone

(918) 756-8371

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Okmulgee Pediatrics & Family Care, L.L.P. Doing business as

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Tax ID family

Okmulgee Pediatrics2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Okmulgee Pediatrics

  • Specialist
  • Okmulgee, OK
  • NPI 1912181348
  NPD tax ID

Locations

Practitioners 3

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

• Kiran Paul, D.O

  • Family Medicine Physician
  • Okmulgee, OK
  • NPI 1225591142
  Medicare reassignment NPD
• Edgar Paul, APRN-CNP

  • Pediatric Nurse Practitioner
  • Okmulgee, OK
  • NPI 1578806659
  NPD (past)
• Naila Paul, M.D.

  • Pediatrics Physician
  • Okmulgee, OK
  • NPI 1619974359
  NPD (past)

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705536000000",
    "number": "1336221688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "916 E 8TH ST",
            "city": "OKMULGEE",
            "state": "OK",
            "postal_code": "744474724",
            "telephone_number": "918-756-8371",
            "fax_number": "918-758-3437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "916 E 8TH ST",
            "city": "OKMULGEE",
            "state": "OK",
            "postal_code": "744474724",
            "telephone_number": "918-756-8371",
            "fax_number": "918-758-3437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OKMULGEE PEDIATRICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "918-756-8371"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100708210B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Okmulgee Pediatrics & Family Care, L.L.P.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Okmulgee Emergency PLLC
• Okmulgee Memorial Hospital
• Okmulgee Memorial Hospital
• Okmulgee Memorial Hospital, Inc
• Okmulgee Pediatrics
• Okmulgee Publilc Schools
• Okmulgee Women'S Healthcare, P.C.
• Okmulgee-Okfuskee County Youth Services, Inc.
• Olakunle D. Ajanaku, MD. PC.
• Omh Home Health

• Pediatrics Physician in Okmulgee, OK
• Providers in Okmulgee, OK by specialty
• Pediatrics Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; 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.