NPIMap

Individual provider Active NPI

John M Hubanks, MD

  • Family Medicine Physician
  • Cheyenne, OK
National Provider Identifier
1477578995
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
14481 Issued in OK
Practice address
101 FK Buster Ave
Cheyenne, OK 73628
Phone
(580) 497-3333
Fax
(580) 497-2778
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 14481 OK Primary

Addresses

Primary practice location

101 FK Buster Ave
Cheyenne, OK 73628

Mailing address

PO Box 490
Cheyenne, OK 73628-0490
Phone (580) 497-3333

Other identifiers 2

IdentifierTypeStateIssuer
100106560AMedicaidOK
1114481OtherOKPRESCRIBER #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041110000165 OK Practitioner - Family Practice 7113980236 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Oklahoma College of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Roger Mills County Hospital AuthorityGroup PAC ID 7113827403, 7 clinicians

Practice addresses (Care Compare)

P O Box
Suite 490
Cheyenne, OK 73628-0490

Hospital & facility affiliations

  • Shepherd Home Health & Hospice, LLC Home health agency, Clinton, OK, CCN 377702
  • Traditions Health of Elk City Hospice, Elk City, OK, CCN 371583
  • Roger Mills Memorial Hospital Hospital, Cheyenne, OK, CCN 371303
  • Great Plains Regional Medical Center Hospital, Elk City, OK, CCN 370019
  • O U Medical Center Hospital, Oklahoma City, OK, CCN 370093

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14481OKMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Roger Mills County Hospital Authority Family Medicine CurrentSince Oct 1, 2004 Accepting new patients
Integris Cardiovascular Physicians LLC Past Accepting new patients
Roger Mills County Hospital Authority PastSince Oct 1, 2004 Accepting new patients
Roger Mills County Hospital Authority Past Accepting new patients
Roger Mills County Hospital Authority Past Accepting new patients

Organizations & group practices 5

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

Hospital & facility affiliations 8

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1477578995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 490",
            "city": "CHEYENNE",
            "state": "OK",
            "postal_code": "736280490",
            "telephone_number": "580-497-3333",
            "fax_number": "580-497-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 FK BUSTER AVE",
            "city": "CHEYENNE",
            "state": "OK",
            "postal_code": "73628",
            "telephone_number": "580-497-3333",
            "fax_number": "580-497-2778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBANKS",
        "first_name": "JOHN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "14481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100106560A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESCRIBER #",
            "identifier": "1114481",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheyenne, OK

Sources for this page

Verify at the official NPI Registry.