Individual provider Active NPI

Stephanie Anne Meeks, D.D.S.

  • General Practice Dentistry
  • Konawa, OK
National Provider Identifier
1578884904
Registry record updated Apr 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6200 Issued in OK
Practice address
527 W 3Rd St
Konawa, OK 74849-1415
Phone
(580) 925-3286
Fax
(580) 925-9149
NPI assigned
Jun 21, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6200 OK Primary

Addresses

Primary practice location

527 W 3Rd St
Konawa, OK 74849-1415

Mailing address

527 W 3Rd St
Konawa, OK 74849-1415
Phone (580) 925-3286

Other identifiers 1

IdentifierTypeStateIssuer
200293320AMedicaidOK

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160301000547 OK Practitioner - Oral Surgery 6709181795 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6200OKMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Central Oklahoma Family Medical Center, Inc. CurrentSince Jan 23, 2016 Accepting new patients
Central Oklahoma Family Medical Center, Inc. Current Accepting new patients
Central Oklahoma Family Medical Center Inc CurrentSince Jan 23, 2016 Accepting new patients

Locations

304 N Monte Vista St
Ada, OK 74820
Phone (405) 584-4078

1221 Arlington St
Ste B
Ada, OK 74820
Phone (580) 332-4700

807 N Monte Vista St
Ada, OK 74820
Phone (580) 279-6413

527 W 3rd St
Konawa, OK 74849
Phone (580) 925-3286

Interoperability endpoints

  • Direct secure messaging: stephanie.meeks@cof.eclinicaldirectplus.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1277078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427932800000",
    "number": "1578884904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "527 W 3RD ST",
            "city": "KONAWA",
            "state": "OK",
            "postal_code": "748491415",
            "telephone_number": "580-925-3286",
            "fax_number": "580-925-9149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 W 3RD ST",
            "city": "KONAWA",
            "state": "OK",
            "postal_code": "748491415",
            "telephone_number": "580-925-3286",
            "fax_number": "580-925-9149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEEKS",
        "first_name": "STEPHANIE",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-21",
        "last_updated": "2015-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "6200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200293320A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Konawa, OK

Sources for this page

Verify at the official NPI Registry.