NPIMap

Organization Active NPI

Sand Springs Medical Associates

  • Family Medicine Physician
  • Sand Springs, OK
National Provider Identifier
1497922496
Registry record updated Aug 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SAND SPRINGS MEDICAL ASSOCIATES
Practice address
401 East Broadway
Suite a
Sand Springs, OK 74063
Phone
(918) 246-3461
Fax
(918) 246-3457
NPI assigned
May 9, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2008

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

Authorized official

Name
Dr. Jack H Brown Jr., MD, DPMNPI 1982699096
Title
Physician
Phone
(918) 246-3461

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

401 East Broadway
Suite a
Sand Springs, OK 74063

Mailing address

401 East Broadway
Suite a
Sand Springs, OK 74063
Phone (918) 246-3461

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081208000160 OK Part B Supplier - Clinic/Group Practice 9436210580 Receives reassigned benefits from 12 practitioners
Practice locations: Sand Springs, OK

National Provider Directory

National Provider Directory

Locations

110 N Garfield Ave
Ste 300
Sand Springs, OK 74063
Phone (918) 246-3456

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1210291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219622400000",
    "number": "1497922496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 EAST BROADWAY",
            "address_2": "SUITE A",
            "city": "SAND SPRINGS",
            "state": "OK",
            "postal_code": "74063",
            "telephone_number": "918-246-3461",
            "fax_number": "918-246-3457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 EAST BROADWAY",
            "address_2": "SUITE A",
            "city": "SAND SPRINGS",
            "state": "OK",
            "postal_code": "74063",
            "telephone_number": "918-246-3461",
            "fax_number": "918-246-3457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAND SPRINGS MEDICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-09",
        "last_updated": "2008-08-25",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "918-246-3461",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD, DPM"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sand Springs, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2008; 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.