Active NPI
Silas Dodgen
- Pharmacist
- Elk City, OK
National Provider Identifier
1477149193
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 15624
- Practice address
- 412 W 3Rd St
Elk City, OK 73644-5202 - Phone
- (580) 225-7961
- NPI assigned
- Dec 16, 2020
- Last updated
- Dec 16, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 15624 | OK | Primary |
Addresses
Primary practice location
412 W 3Rd St
Elk City, OK 73644-5202
Mailing address
412 W 3Rd St
Elk City, OK 73644-5202
Phone (580) 225-7961
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15624 | OK | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hac, Inc. | Current | Accepting new patients | |
| Hac, Inc | Past | Accepting new patients |
Locations
412 W 3rd St
Elk City, OK 73644
Phone (580) 225-7961
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": "1608076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608076800000",
"number": "1477149193",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "412 W 3RD ST",
"city": "ELK CITY",
"state": "OK",
"postal_code": "736445202",
"telephone_number": "580-225-7961"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "412 W 3RD ST",
"city": "ELK CITY",
"state": "OK",
"postal_code": "736445202",
"telephone_number": "580-225-7961"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DODGEN",
"first_name": "SILAS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-16",
"last_updated": "2020-12-16",
"certification_date": "2020-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OK",
"license": "15624",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elk City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.