Organization Active NPI

Miami Womens Clinic Inc

  • Obstetrics & Gynecology Physician
  • Miami, OK
National Provider Identifier
1447331012
Registry record updated Apr 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
03963 Issued in OK
Legal business name
MIAMI WOMENS CLINIC INC
Practice address
310 Second Ave SW
Suite 204
Miami, OK 74354
Phone
(918) 542-4300
Fax
(918) 542-3310
NPI assigned
Oct 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2011

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

Authorized official

Name
Tammie Lynn Koehler, DONPI 1548378375
Title
Physician Owner
Phone
(918) 542-4300

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
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X 03963 OK Primary

Addresses

Primary practice location

310 Second Ave SW
Suite 204
Miami, OK 74354

Mailing address

310 Second Ave SW
Suite 204
Miami, OK 74354
Phone (918) 542-4300

Other identifiers 1

IdentifierTypeStateIssuer
200059700AMedicaidOK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050825000047 OK Part B Supplier - Clinic/Group Practice 2163453606 Receives reassigned benefits from 1 practitioner
Practice locations: Miami, OK

National Provider Directory

National Provider Directory

Locations

310 2nd Ave SW
Ste 204
Miami, OK 74354
Phone (918) 540-7701

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302480000000",
    "number": "1447331012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 SECOND AVE SW",
            "address_2": "SUITE 204",
            "city": "MIAMI",
            "state": "OK",
            "postal_code": "74354",
            "telephone_number": "918-542-4300",
            "fax_number": "918-542-3310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 SECOND AVE SW",
            "address_2": "SUITE 204",
            "city": "MIAMI",
            "state": "OK",
            "postal_code": "74354",
            "telephone_number": "918-542-4300",
            "fax_number": "918-542-3310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIAMI WOMENS CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2011-04-11",
        "status": "A",
        "authorized_official_last_name": "KOEHLER",
        "authorized_official_first_name": "TAMMIE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "918-542-4300",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "OK",
            "license": "03963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200059700A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2011; 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.