Individual provider Active NPI

Michael Zane Rickman, MD

  • Internal Medicine Physician
  • Enid, OK
National Provider Identifier
1497751259
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
10767 Issued in OK
Practice address
721 W Broadway Ave
Enid, OK 73701-3880
Phone
(580) 237-0322
Fax
(580) 233-0402
NPI assigned
Jun 24, 2005
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 10767 OK Primary

Addresses

Primary practice location

721 W Broadway Ave
Enid, OK 73701-3880

Mailing address

721 W Broadway Ave
Enid, OK 73701-3880
Phone (580) 237-0322

Other identifiers 3

IdentifierTypeStateIssuer
100100490AMedicaidOK
730776935003OtherBLUE CROSS
P00061497OtherRAILROAD MEDICARE PTAN

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)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Enid Medical Associates Internal Medicine Past Accepting new patients
St. Mary's Physician Associates, LLC Internal Medicine Past Accepting new patients
Uhs of Oklahoma Inc Past Accepting new patients

Organizations & group practices 3

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": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1497751259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 W BROADWAY AVE",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737013880",
            "telephone_number": "580-237-0322",
            "fax_number": "580-233-0402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 W BROADWAY AVE",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737013880",
            "telephone_number": "580-237-0322",
            "fax_number": "580-233-0402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICKMAN",
        "first_name": "MICHAEL",
        "middle_name": "ZANE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-24",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "10767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100100490A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "730776935003",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "P00061497",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Enid, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.