NPIMap

Organization Active NPI

Diagnostic Laboratory of Oklahoma LLC

  • Clinical Medical Laboratory
  • Blackwell, OK
National Provider Identifier
1376721290
Registry record updated Feb 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
DIAGNOSTIC LABORATORY OF OKLAHOMA LLC
Practice address
710 S 13TH St
Blackwell, OK 74631-3700
Phone
(580) 363-9441
NPI assigned
Feb 1, 2008
Last updated
Feb 1, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
DIAGNOSTIC LABORATORY OF OKLAHOMA LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 1, 2008

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

Authorized official

Name
G Scott Cartier
Title
VP National Billing
Phone
(484) 676-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X OK Primary

Addresses

Primary practice location

710 S 13TH St
Blackwell, OK 74631-3700

Mailing address

2750 Monroe Blvd
Norristown, PA 19403-2429

Other names 1

  • Integris Blackwell Regional Hospital Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040811000543 OK Part B Supplier - Independent Clinical Laboratory 9032181953 20 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Miami, OK; Yukon, OK; Tulsa, OK; Owasso, OK; Oklahoma City, OK; Grove, OK; Enid, OK; Edmond, OK

Other NPIs on the same Medicare enrollment 20

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 20

National Provider Directory

National Provider Directory
Part of
Diagnostic Laboratory O

NPI Registry JSON

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

{
    "created_epoch": "1201824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201824000000",
    "number": "1376721290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2750 MONROE BLVD",
            "city": "NORRISTOWN",
            "state": "PA",
            "postal_code": "194032429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 S 13TH ST",
            "city": "BLACKWELL",
            "state": "OK",
            "postal_code": "746313700",
            "telephone_number": "580-363-9441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAGNOSTIC LABORATORY OF OKLAHOMA LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DIAGNOSTIC LABORATORY OF OKLAHOMA LLC",
        "enumeration_date": "2008-02-01",
        "last_updated": "2008-02-01",
        "status": "A",
        "authorized_official_last_name": "CARTIER",
        "authorized_official_first_name": "G",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "VP NATIONAL BILLING",
        "authorized_official_telephone_number": "484-676-7000"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Integris Blackwell Regional Hospital",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Blackwell, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2008; 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.