NPIMap

Organization Active NPI

Medical Center Pain Clinic, PLLC

  • Pain Clinic/Center
  • Oklahoma City, OK
National Provider Identifier
1477829554
Registry record updated Jul 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Clinic/CenterTaxonomy code 261QP3300X
License
15874 Issued in OK
Legal business name
MEDICAL CENTER PAIN CLINIC, PLLC
Practice address
1226 N Shartel Ave
Suite 300
Oklahoma City, OK 73103
Phone
(405) 232-8003
Fax
(405) 232-8808
NPI assigned
Mar 22, 2012
Last updated
Jul 14, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2018

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

Authorized official

Name
Dr. David Paul Ellis, MDNPI 1487738928
Title
Registered Agent
Phone
(405) 232-8003

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
Pain Clinic/Center 261QP3300X 15874 OK Primary

Addresses

Primary practice location

1226 N Shartel Ave
Suite 300
Oklahoma City, OK 73103

Mailing address

2700 NE 63Rd St
Oklahoma City, OK 73111-8305
Phone (405) 271-5859

Other identifiers 1

IdentifierTypeStateIssuer
200432890AMedicaidOK

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1332374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531526400000",
    "number": "1477829554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 NE 63RD ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731118305",
            "telephone_number": "405-271-5859",
            "fax_number": "405-232-8808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1226 N SHARTEL AVE",
            "address_2": "SUITE 300",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73103",
            "telephone_number": "405-232-8003",
            "fax_number": "405-232-8808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL CENTER PAIN CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-22",
        "last_updated": "2018-07-14",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "REGISTERED AGENT",
        "authorized_official_telephone_number": "405-232-8003",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "OK",
            "license": "15874",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200432890A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2018; 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.