NPIMap

Organization Active NPI

Crescent Infectious Diseases PLLC

  • Infectious Disease Physician
  • Oklahoma City, OK
National Provider Identifier
1538501028
Registry record updated Sep 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
29704 Issued in OK
Legal business name
CRESCENT INFECTIOUS DISEASES PLLC
Practice address
1111 N Lee Ave Ste 249
Oklahoma City, OK 73103-2600
Phone
(888) 219-9988
Fax
(405) 594-5847
NPI assigned
Jul 24, 2013
Last updated
Sep 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2025

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

Authorized official

Name
Heather Harris
Title
Operations Manager
Phone
(888) 219-9988

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 29704 OK Primary

Addresses

Primary practice location

1111 N Lee Ave Ste 249
Oklahoma City, OK 73103-2600

Mailing address

1111 N Lee Ave Ste 249
Oklahoma City, OK 73103-2600
Phone (888) 219-9988

Other practice location 1

129 Ed Noble Pkwy
Norman, OK 73072-4800
Phone (888) 219-9988

Other identifiers 1

IdentifierTypeStateIssuer
29704OtherOKLICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131007000930 OK Part B Supplier - Clinic/Group Practice 8820222847 Receives reassigned benefits from 16 practitioners
Practice locations: Norman, OK; Oklahoma City, OK

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D2345178Crescent Infectious Diseases PLLC1111 N Lee Ave, Ste 249, Oklahoma City, OK 73103Certificate of waiverJun 4, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 16

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 16

NPI Registry JSON

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

{
    "created_epoch": "1374624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758499200000",
    "number": "1538501028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 N LEE AVE STE 249",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731032600",
            "telephone_number": "888-219-9988",
            "fax_number": "405-594-5847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 N LEE AVE STE 249",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731032600",
            "telephone_number": "888-219-9988",
            "fax_number": "405-594-5847"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "129 Ed Noble Pkwy",
            "address_purpose": "LOCATION",
            "city": "Norman",
            "state": "OK",
            "postal_code": "730724800",
            "country_code": "US",
            "telephone_number": "888-219-9988",
            "fax_number": "405-594-5847",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CRESCENT INFECTIOUS DISEASES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-24",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "888-219-9988"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "OK",
            "license": "29704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "29704",
            "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 Sep 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.