Individual provider Active NPI

Carla J Jones, DO

  • Anesthesiology Physician
  • Okmulgee, OK
National Provider Identifier
1487691234
Registry record updated Apr 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
3405 Issued in OK
Practice address
1313 E 20TH St
Okmulgee, OK 74447-6303
Phone
(918) 591-5700
Fax
(918) 756-4490
NPI assigned
Jun 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 3405 OK Primary
Family Medicine Physician 207Q00000X 3405 OK

Addresses

Primary practice location

1313 E 20TH St
Okmulgee, OK 74447-6303

Mailing address

Dept 1467
MCN Primary Clinics
Tulsa, OK 74182-0001
Phone (918) 591-5700

Other identifiers 2

IdentifierTypeStateIssuer
100136620AMedicaidOK
900522349OtherOKMEDICARE GROUP PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, OK2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050324001048 TX Practitioner - AnesthesiologyPractitioner - Family Practice 3870546047 Reassigns benefits to 1 organization
I20060224000097 OK Practitioner - AnesthesiologyPractitioner - Family Practice 3870546047 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Creek Nation Hospital & Clinics CurrentSince Mar 13, 2013 Accepting new patients
Lawton Indian Hospital CurrentSince Apr 19, 2017 Accepting new patients
Creek Nation Hospital & Clinics Family Medicine Current Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Mar 13, 2013 Accepting new patients
Southcrest Anesthesia Group LLC Anesthesiology Past Accepting new patients
Ahs Oklahoma Physician Group LLC Family Medicine Past Accepting new patients

Locations

1515 NE Lawrie Tatum Rd
Lawton, OK 73507
Phone (580) 353-0350

309 N 14th St
Okemah, OK 74859
Phone (918) 623-1424

900 E Airport Rd
Okmulgee, OK 74447
Phone 91875643334448

1313 E 20th St
Okmulgee, OK 74447
Phone (918) 591-5700

1125 E Cleveland Ave
Sapulpa, OK 74066
Phone (918) 224-9310

Dept 1467
Tulsa, OK 74182

Interoperability endpoints

  • FHIR API: https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430092800000",
    "number": "1487691234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 1467",
            "address_2": "MCN PRIMARY CLINICS",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741820001",
            "telephone_number": "918-591-5700",
            "fax_number": "918-756-4490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 E 20TH ST",
            "city": "OKMULGEE",
            "state": "OK",
            "postal_code": "744476303",
            "telephone_number": "918-591-5700",
            "fax_number": "918-756-4490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "CARLA",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-01",
        "last_updated": "2015-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OK",
            "license": "3405",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "3405",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100136620A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PIN",
            "identifier": "900522349",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Okmulgee, OK

Sources for this page

Verify at the official NPI Registry.