NPIMap

Organization Active NPI

Oklahoma West Physicians Group

  • Family Medicine Physician
  • Hydro, OK
National Provider Identifier
1457531600
Registry record updated Nov 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
3099 Issued in OK
Legal business name
OKLAHOMA WEST PHYSICIANS GROUP
Practice address
579 N Broadway Ave
Hydro, OK 73048-8425
Phone
(405) 663-2291
Fax
(405) 663-2121
NPI assigned
Nov 5, 2007
Last updated
Nov 5, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2007

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

Authorized official

Name
Dr. Brenda R Stutzman, DONPI 1700880127
Title
Physician
Phone
(405) 663-2291

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 3099 OK Primary

Addresses

Primary practice location

579 N Broadway Ave
Hydro, OK 73048-8425

Mailing address

579 N Broadway Ave
Hydro, OK 73048-8425
Phone (405) 663-2291

Other identifiers 1

IdentifierTypeStateIssuer
446748104001OtherOKBLUE CROSS/BLUE SHIELD

National Provider Directory

National Provider Directory
Tax ID family
Oklahoma W Phys Group6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

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": "1194220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194220800000",
    "number": "1457531600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "579 N BROADWAY AVE",
            "city": "HYDRO",
            "state": "OK",
            "postal_code": "730488425",
            "telephone_number": "405-663-2291",
            "fax_number": "405-663-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "579 N BROADWAY AVE",
            "city": "HYDRO",
            "state": "OK",
            "postal_code": "730488425",
            "telephone_number": "405-663-2291",
            "fax_number": "405-663-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OKLAHOMA WEST PHYSICIANS GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-05",
        "last_updated": "2007-11-05",
        "status": "A",
        "authorized_official_last_name": "STUTZMAN",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "405-663-2291",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "3099",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "446748104001",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hydro, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2007; 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.