Oklahoma Wellness Group LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

OKLAHOMA WELLNESS GROUP LLC

Practice address

14101 North Esatern Avenue Suite B
Edmond, OK 73013

Phone

(405) 513-6655

Fax

(405) 513-6589

NPI assigned

Nov 7, 2018

Organization subpart

No

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

Authorized official

Name

William G Reilly, MD

Title

Authorized Official

Phone

(817) 410-3800

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1541548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541548800000",
    "number": "1578031571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 EAST STATE HIGHWAY 114",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "76092",
            "telephone_number": "817-410-3800",
            "fax_number": "817-410-6466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14101 NORTH ESATERN AVENUE SUITE B",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "73013",
            "telephone_number": "405-513-6655",
            "fax_number": "405-513-6589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OKLAHOMA WELLNESS GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-07",
        "last_updated": "2018-11-07",
        "status": "A",
        "authorized_official_last_name": "REILLY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "817-410-3800",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Edmond, OK
• Providers in Edmond, OK by specialty
• Internal Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2018; 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.