Oak Medical Practice, P.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

OAK MEDICAL PRACTICE, P.C.

Practice address

2001 W 21St St
Clovis, NM 88101-4086

Phone

(575) 935-1625

Fax

(575) 935-1626

NPI assigned

Dec 10, 2010

Organization subpart

No

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

Authorized official

Name

Oyinkan Kokoricha

Title

Office Manager

Phone

(575) 935-1625

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1291939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398211200000",
    "number": "1376846568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 W 21ST ST",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881014086",
            "telephone_number": "575-935-1625",
            "fax_number": "575-935-1626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 W 21ST ST",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881014086",
            "telephone_number": "575-935-1625",
            "fax_number": "575-935-1626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAK MEDICAL PRACTICE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-10",
        "last_updated": "2014-04-23",
        "status": "A",
        "authorized_official_last_name": "KOKORICHA",
        "authorized_official_first_name": "OYINKAN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "575-935-1625"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2014; 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.