NPIMap

Organization Active NPI

McCurtain Memorial Medical Management, Inc.

  • Diagnostic Radiology Physician
  • Idabel, OK
National Provider Identifier
1376757401
Registry record updated Jun 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
MCCURTAIN MEMORIAL MEDICAL MANAGEMENT, INC.
Practice address
1301 E Lincoln Road
Idabel, OK 74745-7300
Phone
(580) 208-3100
Fax
(580) 208-3199
NPI assigned
May 9, 2007
Last updated
Jun 16, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
MCCURTAIN MEMORIAL MEDICAL MANAGEMENT, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 16, 2008

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

Authorized official

Name
Mr. Ray B Whitmore Jr.
Title
Cfo
Phone
(580) 208-3104

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X Primary
Diagnostic Ultrasound PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085U0001X

Addresses

Primary practice location

1301 E Lincoln Road
Idabel, OK 74745-7300

Mailing address

1301 E Lincoln Road
Idabel, OK 74745-7300
Phone (580) 208-3100

Other identifiers 1

IdentifierTypeStateIssuer
100700920BMedicaidOK

Other names 1

  • McCurtain Memorial Hospital Radiology Phy Other name

National Provider Directory

National Provider Directory
Tax ID family
MCC Mem Med SVC16 organizations share this tax ID, including this one
Part of
MCC Mem Med SVC

Other organizations with this tax ID 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1376757401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 E LINCOLN ROAD",
            "city": "IDABEL",
            "state": "OK",
            "postal_code": "747457300",
            "telephone_number": "580-208-3100",
            "fax_number": "580-208-3199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 E LINCOLN ROAD",
            "city": "IDABEL",
            "state": "OK",
            "postal_code": "747457300",
            "telephone_number": "580-208-3100",
            "fax_number": "580-208-3199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCCURTAIN MEMORIAL MEDICAL MANAGEMENT, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MCCURTAIN MEMORIAL MEDICAL MANAGEMENT, INC.",
        "enumeration_date": "2007-05-09",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "WHITMORE",
        "authorized_official_first_name": "RAY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "580-208-3104",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100700920B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McCurtain Memorial Hospital Radiology Phy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Idabel, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.