Individual provider Active NPI

Gregory Phillip Root, D.O.

  • Obstetrics & Gynecology Physician
  • Yukon, OK
National Provider Identifier
1467748889
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
5273 Issued in OK
Practice address
1205 Health Center Pkwy Ste 240
Yukon, OK 73099-6396
Phone
(405) 717-5496
Fax
(405) 717-5499
NPI assigned
Jun 23, 2011
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 5273 OK Primary

Addresses

Primary practice location

1205 Health Center Pkwy Ste 240
Yukon, OK 73099-6396

Mailing address

5300 N Independence Ave Ste 280
Oklahoma City, OK 73112-5555
Phone (405) 717-5496

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150916001149 OK Practitioner - Obstetrics/Gynecology 0042527541 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Oklahoma State University College of Osteopathic Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integris Ambulatory Care CorporationGroup PAC ID 2365408465, 687 clinicians

Practice addresses (Care Compare)

1205 Health Ctr Pkwy
Suite 240a
Yukon, OK 73099-6396
Phone (405) 717-5496

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5273OKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Oklahoma City Gynecology and Obstetrics, LLC Obstetrics & Gynecology CurrentSince Jan 21, 2020 Accepting new patients
Integris Ambulatory Care Corporation Obstetrics & Gynecology CurrentSince Aug 14, 2017 Accepting new patients
Integris Canadian Valley Hospital Past Accepting new patients
Integris Ambulatory Care C Orporation Past Accepting new patients

Locations

11200 N Portland Ave
Oklahoma City, OK 73120
Phone (405) 936-1000

3400 NW Expressway
Ste 500
Oklahoma City, OK 73112
Phone (405) 945-4589

5300 N Independence Ave
Ste 280
Oklahoma City, OK 73112
Phone (405) 552-0155

1205 Health Center Pkwy
Ste 240A
Yukon, OK 73099
Phone (405) 717-5496

Interoperability endpoints

  • Direct secure messaging: gregory.root.1@3062.direct.athenahealth.com
  • Direct secure messaging: groot84821@direct.integrisok.com

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1467748889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 N INDEPENDENCE AVE STE 280",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731125555",
            "telephone_number": "405-717-5496",
            "fax_number": "405-717-5499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 HEALTH CENTER PKWY STE 240",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730996396",
            "telephone_number": "405-717-5496",
            "fax_number": "405-717-5499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOT",
        "first_name": "GREGORY",
        "middle_name": "PHILLIP",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-23",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OK",
            "license": "5273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yukon, OK

Sources for this page

Verify at the official NPI Registry.