Organization Active NPI

Doc Blythe PLLC

  • Orthopaedic Surgery of the Spine Physician
  • Oklahoma City, OK
National Provider Identifier
1376303289
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
Legal business name
DOC BLYTHE PLLC
Practice address
13100 N Western Ave Ste 200
Oklahoma City, OK 73114-1431
Phone
(405) 418-4500
Fax
(405) 418-4501
NPI assigned
Mar 19, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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

Authorized official

Name
Randall Murray
Title
Practice Manager
Phone
(405) 418-4500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207XS0117X Primary

Addresses

Primary practice location

13100 N Western Ave Ste 200
Oklahoma City, OK 73114-1431

Mailing address

13100 N Western Ave Ste 200
Oklahoma City, OK 73114-1431
Phone (405) 418-4500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20240528000718 OK Part B Supplier - Clinic/Group Practice 1557703261 Receives reassigned benefits from 1 practitioner
Practice locations: Oklahoma City, OK
O20250103002557 OK DME Supplier - Physician - Orthopedic/Orthopedic Surgery 1557703261 Practice locations: Oklahoma City, OK

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1710806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710806400000",
    "number": "1376303289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13100 N WESTERN AVE STE 200",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731141431",
            "telephone_number": "405-418-4500",
            "fax_number": "405-418-4501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13100 N WESTERN AVE STE 200",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731141431",
            "telephone_number": "405-418-4500",
            "fax_number": "405-418-4501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOC BLYTHE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-19",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A",
        "authorized_official_last_name": "MURRAY",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "405-418-4500"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 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.