Individual provider Active NPI

Koby Hunter, DO

  • Emergency Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1518337484
Registry record updated Oct 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0106R Issued in OK
Practice address
4401 S Western Ave
Oklahoma City, OK 73109-3413
Phone
(405) 636-7000
NPI assigned
Oct 4, 2015
Last updated
Oct 4, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 0106R OK Primary

Addresses

Primary practice location

4401 S Western Ave
Oklahoma City, OK 73109-3413

Mailing address

4401 S Western Ave
Oklahoma City, OK 73109-3413
Phone (405) 636-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161116002836 OK Practitioner - Emergency Medicine 9335428218 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Oklahoma CommunitiesGroup PAC ID 1153468921, 645 clinicians

Practice addresses (Care Compare)

1011 14TH Ave NW
Ardmore, OK 73401-1828
Phone (580) 220-6132

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
0106ROKMDEmergency Medicine Physician
5998OKMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Kingfisher, Inc Current Accepting new patients
Emergency Services of Oklahoma PC Emergency Medicine CurrentSince Oct 21, 2017 Accepting new patients
Mercy Hospital Kingfisher, Inc CurrentSince Aug 28, 2017 Accepting new patients
Mercy Hospital Logan County Inc Current Accepting new patients
Mercy Clinic Oklahoma Communities CurrentSince Jan 15, 2021 Accepting new patients
Mercy Hospital Logan County, Inc CurrentSince Aug 28, 2017 Accepting new patients
Mercy Hospital Logan County, Inc CurrentSince Aug 28, 2017 Accepting new patients
Mercy Hospital Ardmore, Inc. Past Accepting new patients
Love County Health Center Past Accepting new patients

Locations

1011 14th Ave NW
Ardmore, OK 73401
Phone (580) 220-6658

200 S Academy Rd
Guthrie, OK 73044
Phone (405) 260-4165

1000 Hospital Dr
Kingfisher, OK 73750
Phone (405) 375-3141

4050 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 608-3200

4300 McAuley Blvd
Oklahoma City, OK 73120
Phone (405) 936-5455

4300 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 752-3962

4401 S Western Ave
Oklahoma City, OK 73109
Phone (405) 636-7000

Organizations & group practices 9

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1443916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443916800000",
    "number": "1518337484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 S WESTERN AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731093413",
            "telephone_number": "405-636-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 S WESTERN AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731093413",
            "telephone_number": "405-636-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUNTER",
        "first_name": "KOBY",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-04",
        "last_updated": "2015-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "0106R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.