NPIMap

Individual provider Active NPI

Aubrey A Kavanaugh, M.D.

  • Family Medicine Physician
  • Midwest City, OK
National Provider Identifier
1487966313
Registry record updated Jan 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
27836 Issued in OK
Practice address
8800 SE 15
Midwest City, OK 73110-8001
Phone
(405) 739-6840
Fax
(405) 455-3087
NPI assigned
Jul 8, 2010
Last updated
Jan 25, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2016

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 27836 OK Primary

Addresses

Primary practice location

8800 SE 15
Midwest City, OK 73110-8001

Mailing address

8800 SE 15
Midwest City, OK 73110-8001
Phone (405) 739-6840

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
I20120215000683 OK Practitioner - Family Practice 6709044092 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Oklahoma College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Great Plains Medical FoundationGroup PAC ID 9335188184, 12 clinicians
Midwest Medical Group PLLCGroup PAC ID 2365342672, 5 clinicians

Practice addresses (Care Compare)

3625 NW 56TH St
Suite 200
Oklahoma City, OK 73112-4509
Phone (405) 951-2855

8800 SE 15TH St
Midwest City, OK 73110-8001
Phone (405) 739-6840

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions15
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Great Plains Medical Foundation Family Medicine CurrentSince Jan 22, 2018 Accepting new patients
Midwest Medical Group PLLC Family Medicine CurrentSince Jan 1, 2013 Accepting new patients
Summit Medical Center Past Accepting new patients
Midwest Radiology Associates PC PastSince Feb 5, 1990 Accepting new patients
Integris Baptist Medical Center Inc Past Accepting new patients

Locations

1201 S Douglas Blvd
Ste J
Oklahoma City, OK 73130
Phone (405) 739-6840

3625 NW 56th St
Ste 200
Oklahoma City, OK 73112
Phone (405) 951-2855

8800 SE 15th St
Oklahoma City, OK 73110
Phone (405) 610-4411

Interoperability endpoints

  • Direct secure messaging: akavan01@yourcarecommunity.org
  • Direct secure messaging: akavanaugh147640@direct.integrisok.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/ADIBBA

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1278547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453680000000",
    "number": "1487966313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8800 SE 15",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731108001",
            "telephone_number": "405-739-6840",
            "fax_number": "405-455-3087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8800 SE 15",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731108001",
            "telephone_number": "405-739-6840",
            "fax_number": "405-455-3087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAVANAUGH",
        "first_name": "AUBREY",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-08",
        "last_updated": "2016-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "27836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midwest City, OK

Sources for this page

Verify at the official NPI Registry.