Organization Active NPI

Long Term Care Specialists, Inc

  • Geriatric Medicine (Family Medicine) Physician
  • Oklahoma City, OK
National Provider Identifier
1497761159
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
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
Last updated
Oct 22, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061030000218 OK Part B Supplier - Clinic/Group Practice 3476550740 Receives reassigned benefits from 42 practitioners

National Provider Directory

National Provider Directory

Locations

2316 W Modelle Ave
Clinton, OK 73601
Phone (580) 323-0912

1000 Elkwood Blvd
Elk City, OK 73644
Phone (580) 225-0506

301 W Broadway St
Lexington, OK 73051
Phone (405) 527-6519

1017 W State Highway 152
Mustang, OK 73064
Phone (405) 376-1200

3233 NW 10th St
Oklahoma City, OK 73107
Phone (405) 943-8366

4825 NW 23rd St
#One
Oklahoma City, OK 73127
Phone (405) 945-0010

5512 S Western Ave
Oklahoma City, OK 73109
Phone (405) 632-2318

6100 N Pennsylvania Ave
Oklahoma City, OK 73112
Phone (405) 463-2212

2616 Turner St
Ponca City, OK 74604
Phone (580) 765-5900

1215 W 10th Ave
Stillwater, OK 74074
Phone (405) 262-2833

104 SE 4th St
Tuttle, OK 73089
Phone (405) 381-3363

1110 Cornwell Dr
Yukon, OK 73099
Phone (405) 350-2311

Practitioners & affiliated clinicians

Practitioners 43

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.

View all 43

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": [],
    "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.

Verify at the official NPI Registry.