NPIMap

Organization Active NPI

Cardiology Services of Enid

  • Cardiovascular Disease Physician
  • Enid, OK
National Provider Identifier
1508891789
Registry record updated Feb 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
CARDIOLOGY SERVICES OF ENID
Practice address
707 S Monroe St
Enid, OK 73701-7286
Phone
(580) 616-7630
Fax
(580) 237-7516
NPI assigned
Jul 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2011

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

Authorized official

Name
Jeff M Brown
Title
VP Rural Physician Pract MGMT
Phone
(580) 548-1367

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

707 S Monroe St
Enid, OK 73701-7286

Mailing address

Dept 960278
Oklahoma City, OK 73196-0278
Phone (580) 548-1367

Other identifiers 2

IdentifierTypeStateIssuer
200106320AMedicaidOK
200608360AMedicaidKS

National Provider Directory

National Provider Directory

Locations

620 S Madison St
Ste 203
Enid, OK 73701
Phone (580) 213-9760

Dept 960278
Oklahoma City, OK 73196

Practitioners & affiliated clinicians

Practitioners 5

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": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298592000000",
    "number": "1508891789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 960278",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731960278",
            "telephone_number": "580-548-1367",
            "fax_number": "580-548-1583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 S MONROE ST",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737017286",
            "telephone_number": "580-616-7630",
            "fax_number": "580-237-7516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIOLOGY SERVICES OF ENID",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2011-02-25",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "JEFF",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "VP RURAL PHYSICIAN PRACT MGMT",
        "authorized_official_telephone_number": "580-548-1367"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200106320A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200608360A",
            "state": "KS"
        }
    ],
    "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 Feb 25, 2011; 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.