Individual provider Active NPI

Dennis Keith McIntyre, MD

  • Internal Medicine Physician
  • Enid, OK
National Provider Identifier
1407840846
Registry record updated Aug 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
12284 Issued in OK
Practice address
721 W Broadway Ave Ste D
Enid, OK 73701-3800
Phone
(580) 237-0322
Fax
(580) 233-0402
NPI assigned
Aug 31, 2005
Last updated
Aug 19, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 12284 OK Primary

Addresses

Primary practice location

721 W Broadway Ave Ste D
Enid, OK 73701-3800

Mailing address

PO Box 3046
Malvern, PA 19355-0746
Phone (580) 242-3090

Other identifiers 1

IdentifierTypeStateIssuer
100100500DMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
12284OKMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Springs Internal Medicine Inc CurrentSince Dec 26, 2008 Accepting new patients
Uhs of Oklahoma Inc Past Accepting new patients

Locations

615 E Oklahoma Ave
Ste 208
Enid, OK 73701
Phone (580) 242-3090

Interoperability endpoints

  • Direct secure messaging: dennis.mcintyre@ipmcentral.cernerdirect.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566172800000",
    "number": "1407840846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3046",
            "city": "MALVERN",
            "state": "PA",
            "postal_code": "193550746",
            "telephone_number": "580-242-3090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 W BROADWAY AVE STE D",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737013800",
            "telephone_number": "580-237-0322",
            "fax_number": "580-233-0402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTYRE",
        "first_name": "DENNIS",
        "middle_name": "KEITH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2019-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "12284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100100500D",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 19, 2019; 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.