Active NPI
Spectra Family Medical Clinic LLC
- Legal Medicine
- Midwest City, OK
National Provider Identifier
1386812345
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Legal Medicine
- License
- 8459
- Legal business name
- SPECTRA FAMILY MEDICAL CLINIC LLC
- Practice address
- 6520 E Reno
Suite a
Midwest City, OK 73110-2109 - Phone
- (405) 733-0120
- Fax
- (405) 733-7876
- NPI assigned
- Feb 13, 2008
- Last updated
- Mar 12, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Davondra Love Owens
- Title
- Cfo
- Phone
- (405) 733-0120
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Legal Medicine | 173000000X | 8459 | OK | Primary |
Addresses
Primary practice location
6520 E Reno
Suite a
Midwest City, OK 73110-2109
Mailing address
PO Box 223
Spencer, OK 73084-0223
Phone (405) 733-0120
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200131340A | Medicaid | OK |
National Provider Directory
National Provider DirectoryLocations
9826 NE 23rd St
Oklahoma City, OK 73141
Phone (405) 259-8105
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Medicine Physician
- Norman, OK
- NPI 1861464752
-
- Physician Assistant
- Norman, OK
- NPI 1043450448
-
- Occupational Medicine Physician
- Oklahoma City, OK
- NPI 1417120023
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202860800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1363046400000",
"number": "1386812345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 223",
"city": "SPENCER",
"state": "OK",
"postal_code": "730840223",
"telephone_number": "405-733-0120",
"fax_number": "405-733-7876"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6520 E RENO",
"address_2": "SUITE A",
"city": "MIDWEST CITY",
"state": "OK",
"postal_code": "731102109",
"telephone_number": "405-733-0120",
"fax_number": "405-733-7876"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SPECTRA FAMILY MEDICAL CLINIC LLC",
"organizational_subpart": "NO",
"enumeration_date": "2008-02-13",
"last_updated": "2013-03-12",
"status": "A",
"authorized_official_last_name": "OWENS",
"authorized_official_first_name": "DAVONDRA",
"authorized_official_middle_name": "LOVE",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "405-733-0120",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "173000000X",
"taxonomy_group": "",
"desc": "Legal Medicine",
"state": "OK",
"license": "8459",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200131340A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Midwest City, OK
- Bradley Alan Spangler
- Claire Sparks
- Madison Lynn Sparks, PA-C
- Emily Spears, RBT
- Specialty Hospital of Midwest City Operator LLC (Specialty Hospital of Midwest City)
- Spectra Mental Health
- Spectra Urgent Care, LLP (Spectra Medical Care)
- Spencer Family Dentistry
- Lauran Ruth Spencer, D.D.S.
- Madison Rhea Spencer, MOTR/L
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.