Active NPI
Long Term Care Specialists, Inc
- Geriatric Medicine (Family Medicine) Physician
- Oklahoma City, OK
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Family Medicine) Physician
- Legal business name
- LONG TERM CARE SPECIALISTS, INC
- Practice address
- 5721 NW 132ND St
Oklahoma City, OK 73142-4437 - Phone
- (405) 557-1200
- Fax
- (405) 557-1977
- NPI assigned
- Aug 1, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jillian Herndon
- Title
- Billing Director
- Phone
- (405) 557-1200
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Family Medicine) Physician | 207QG0300X | Primary |
Addresses
Primary practice location
5721 NW 132ND St
Oklahoma City, OK 73142-4437
Mailing address
5721 NW 132ND St
Oklahoma City, OK 73142-4437
Phone (405) 557-1200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100736840A | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20061030000218 | OK | Part B Supplier - Clinic/Group Practice | 3476550740 | Receives reassigned benefits from 42 practitioners |
National Provider Directory
National Provider DirectoryLocations
1000 Elkwood Blvd
Elk City, OK 73644
Phone (580) 225-0506
1001 S George Nigh Expy
McAlester, OK 74501
Phone (918) 423-7373
616 S Front St
Medford, OK 73759
Phone (580) 395-2105
5800 W Okmulgee St
Muskogee, OK 74401
Phone (918) 683-2914
5512 S Western Ave
Oklahoma City, OK 73109
Phone (405) 632-2318
4825 NW 23rd St
#One
Oklahoma City, OK 73127
Phone (405) 945-0010
5600 S Walker Ave
Oklahoma City, OK 73109
Phone (405) 632-7771
2200 N Coltrane Rd
Oklahoma City, OK 73121
Phone (405) 427-1322
6100 N Pennsylvania Ave
Oklahoma City, OK 73112
Phone (405) 463-2212
3804 N Barr Ave
Oklahoma City, OK 73122
Phone (405) 789-7102
1228 Pecan
Pawhuska, OK 74056
Phone (918) 287-3940
2616 Turner St
Ponca City, OK 74604
Phone (580) 765-5900
Practitioners & affiliated clinicians
Practitioners 43
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1729555200000",
"number": "1497761159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5721 NW 132ND ST",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731424437",
"telephone_number": "405-557-1200",
"fax_number": "405-557-1977"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5721 NW 132ND ST",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731424437",
"telephone_number": "405-557-1200",
"fax_number": "405-557-1977"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LONG TERM CARE SPECIALISTS, INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-01",
"last_updated": "2024-10-22",
"certification_date": "2024-10-22",
"status": "A",
"authorized_official_last_name": "HERNDON",
"authorized_official_first_name": "JILLIAN",
"authorized_official_title_or_position": "BILLING DIRECTOR",
"authorized_official_telephone_number": "405-557-1200"
},
"taxonomies": [
{
"code": "207QG0300X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine, Geriatric Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100736840A",
"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 Oct 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.