NPIMap

Organization Active NPI

Northwest Oklahoma Orthopaedic Clinic Inc

Doing business as Northwest Oklahoma Orthopaedic Clinic PC

  • Surgery Physician
  • Enid, OK
National Provider Identifier
1407063266
Registry record updated Aug 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
NORTHWEST OKLAHOMA ORTHOPAEDIC CLINIC INC
Doing business as
Northwest Oklahoma Orthopaedic Clinic PC
Practice address
900 W Cherokee Ave
Enid, OK 73701-5410
Phone
(580) 233-6707
Fax
(580) 233-3724
NPI assigned
May 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2025

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

Authorized official

Name
David Edward KellerNPI 1487734026
Title
President
Phone
(580) 233-6707

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

900 W Cherokee Ave
Enid, OK 73701-5410

Mailing address

PO Box 1484
Enid, OK 73702-1484
Phone (580) 233-6707

Other practice location 1

4900 Oklahoma Ave
Woodward, OK 73801-3713
Phone (580) 254-5316

Other identifiers 2

IdentifierTypeStateIssuer
100730140DMedicaidOK
100730140CMedicaidOK

Other names 1

  • Northwest Oklahoma Orthopaedic Clinic PC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040519000503 OK Part B Supplier - Clinic/Group Practice 3870584931 Receives reassigned benefits from 10 practitioners
Practice locations: Enid, OK
O20200320000759 OK DME Supplier - Physician - Orthopedic/Orthopedic SurgeryDME Supplier - Independently-Practicing Physical Therapist 3870584931 Practice locations: Enid, OK

National Provider Directory

National Provider Directory

Locations

330 S 5th St
Ste 501
Enid, OK 73701
Phone (580) 233-6707

900 W Cherokee Ave
#501
Enid, OK 73701

900 W Cherokee Ave
Enid, OK 73701
Phone (580) 233-6707

Practitioners & affiliated clinicians

Practitioners 11

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": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755043200000",
    "number": "1407063266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1484",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737021484",
            "telephone_number": "580-233-6707",
            "fax_number": "580-233-3724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 W CHEROKEE AVE",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737015410",
            "telephone_number": "580-233-6707",
            "fax_number": "580-233-3724"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4900 Oklahoma Ave",
            "address_purpose": "LOCATION",
            "city": "Woodward",
            "state": "OK",
            "postal_code": "738013713",
            "country_code": "US",
            "telephone_number": "580-254-5316",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NORTHWEST OKLAHOMA ORTHOPAEDIC CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A",
        "authorized_official_last_name": "KELLER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "580-233-6707"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100730140D",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100730140C",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northwest Oklahoma Orthopaedic Clinic PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Enid, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2025; 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.