Innovative Medical Associates PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

INNOVATIVE MEDICAL ASSOCIATES PLLC

Practice address

4301 NW 63Rd St
Suite 205
Oklahoma City, OK 73116-1549

Phone

(405) 242-6494

Fax

(405) 242-6496

NPI assigned

May 23, 2007

Organization subpart

No

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

Authorized official

Name

Vatsala Shah, MDNPI 1376535328

Title

Managing Partner

Phone

(405) 553-1540

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Vatsala Niranjan Shah, MD

  • Internal Medicine Physician
  • Oklahoma City, OK
  • NPI 1376535328
  Medicare reassignment NPD Authorized official
• David Michael Bailey, MD

  • Internal Medicine Physician
  • Oklahoma City, OK
  • NPI 1639161672
  NPD (past)
• Terry Nizo Copeland, MD

  • Internal Medicine Physician
  • Oklahoma City, OK
  • NPI 1043202096
  NPD (past)
• Jon Christopher Liprie, M.D.

  • Hospitalist Physician
  • Lafayette, LA
  • NPI 1528130481

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452124800000",
    "number": "1407066228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 W MAIN ST",
            "address_2": "SUITE 205",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730696824",
            "telephone_number": "405-292-5500",
            "fax_number": "405-292-5505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 NW 63RD ST",
            "address_2": "SUITE 205",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731161549",
            "telephone_number": "405-242-6494",
            "fax_number": "405-242-6496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE MEDICAL ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2016-01-07",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "VATSALA",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "405-553-1540",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100748720A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Innovative Community Resource Specialist
• Innovative Prothestics and Research, LLC
• Innovative Senior Care Home Health of Edmond LLC
• Innovo Counseling and Consulting, Inc.
• Inoveon Corporation
• Insight Dental and Implants

• Internal Medicine Physician in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Internal Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2016; 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.