Organization Active NPI

Arbuckle Internal Medicine Group,PLLC

  • Internal Medicine Physician
  • Sulphur, OK
National Provider Identifier
1386970200
Registry record updated Mar 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
23001 Issued in OK
Legal business name
ARBUCKLE INTERNAL MEDICINE GROUP,PLLC
Practice address
921 W 11TH St
Ste 2
Sulphur, OK 73086-4459
Phone
(580) 622-2353
Fax
(580) 622-2351
NPI assigned
Oct 28, 2009
Last updated
Mar 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2025

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

Authorized official

Name
Jonathan Ohenhen, MDNPI 1285703249
Title
Ceo
Phone
(580) 622-2353

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU
Internal Medicine Physician 207R00000X 23001 OK Primary

Addresses

Primary practice location

921 W 11TH St
Ste 2
Sulphur, OK 73086-4459

Mailing address

921 W 11TH St
Ste 2
Sulphur, OK 73086-4459
Phone (580) 622-2353

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091112000548 OK Part B Supplier - Clinic/Group Practice 3375681216 Receives reassigned benefits from 1 practitioner
Practice locations: Sulphur, OK

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D2004203Arbuckle Internal Medicine Group, Inc921 W 11TH St, Ste 2, Sulphur, OK 73086Certificate of waiverJun 25, 2027

National Provider Directory

National Provider Directory

Locations

921 W 11th St
#2
Sulphur, OK 73086
Phone (580) 622-2353

921 W 11th St
Ste 2
Sulphur, OK 73086
Phone (580) 622-2353

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1256688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742601600000",
    "number": "1386970200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 W 11TH ST",
            "address_2": "STE 2",
            "city": "SULPHUR",
            "state": "OK",
            "postal_code": "730864459",
            "telephone_number": "580-622-2353",
            "fax_number": "580-622-2351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 W 11TH ST",
            "address_2": "STE 2",
            "city": "SULPHUR",
            "state": "OK",
            "postal_code": "730864459",
            "telephone_number": "580-622-2353",
            "fax_number": "580-622-2351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARBUCKLE INTERNAL MEDICINE GROUP,PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-28",
        "last_updated": "2025-03-22",
        "certification_date": "2025-03-22",
        "status": "A",
        "authorized_official_last_name": "OHENHEN",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "580-622-2353",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "23001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sulphur, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.