Individual provider Active NPI

Lynn A McClintock, M.D.

  • Family Medicine Physician
  • Muskogee, OK
National Provider Identifier
1366411282
Registry record updated May 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
16490 Issued in OK
Practice address
350 S 40TH St
Muskogee, OK 74401-4915
Phone
(918) 683-0753
Fax
(918) 683-5677
NPI assigned
Mar 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 16490 OK Primary

Addresses

Primary practice location

350 S 40TH St
Muskogee, OK 74401-4915

Mailing address

350 S 40TH St
Muskogee, OK 74401-4915
Phone (918) 683-0753

Other identifiers 1

IdentifierTypeStateIssuer
100131220AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20101201000134 OK Practitioner - Family Practice 3173719200 Reassigns benefits to 2 organizations
I20180615001434 TX Practitioner - Family Practice 3173719200 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
16490OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Omni Medical Group Inc Family Medicine CurrentSince Oct 1, 1994 Accepting new patients
Cherokee Nation CurrentSince May 2, 2018 Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients
St. John Physicians, Inc CurrentSince Jan 2, 2011 Accepting new patients
Cherokee Nation CurrentSince May 2, 2018 Accepting new patients
St. John Physicians, Inc. Family Medicine CurrentSince Jan 2, 2011 Accepting new patients

Locations

1222 N Florence Ave
#4
Claremore, OK 74017

859 E Melton Dr
Jay, OK 74346
Phone (918) 253-4271

1001 S 41st St E
#3
Muskogee, OK 74403
Phone (918) 687-0201

1020 Lenape Dr
Nowata, OK 74048
Phone (918) 273-0192

900 N Owen Walters Blvd
Salina, OK 74365
Phone (918) 434-8500

100 S Bliss Ave
Tahlequah, OK 74464
Phone (918) 458-3100

Dept 2269
Tulsa, OK 74182

1923 S Utica Ave
Tulsa, OK 74104
Phone (918) 744-2345

1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585

Dept 852
Tulsa, OK 74182

27371 S 4410 Rd
Vinita, OK 74301
Phone (918) 256-4800

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558051200000",
    "number": "1366411282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 S 40TH ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744014915",
            "telephone_number": "918-683-0753",
            "fax_number": "918-683-5677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 S 40TH ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744014915",
            "telephone_number": "918-683-0753",
            "fax_number": "918-683-5677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLINTOCK",
        "first_name": "LYNN",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2019-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "16490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100131220A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskogee, OK

Sources for this page

Verify at the official NPI Registry.