Individual provider Active NPI

Sara Brewer, DO

  • Pediatrics Physician
  • Oklahoma City, OK
National Provider Identifier
1588004907
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
24384 Issued in MS
Practice address
1200 Everett Dr Ofc 7514
Oklahoma City, OK 73104-5047
Phone
(405) 271-5215
NPI assigned
Jun 29, 2013
Last updated
Dec 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X T-2647 MS
Pediatrics Physician 208000000X 24384 MS Primary

Addresses

Primary practice location

1200 Everett Dr Ofc 7514
Oklahoma City, OK 73104-5047

Mailing address

202 Russell M Perry Ave
Oklahoma City, OK 73104-4018
Phone (405) 271-5215

Other identifiers 1

IdentifierTypeStateIssuer
06827817MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, OK2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160621002209 MS Practitioner - Pediatric Medicine 1850616368 Reassigns benefits to 1 organization
I20211209002196 OK Practitioner - Pediatric Medicine 1850616368 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7490OKMDCase Manager/Care Coordinator
T-2647MSMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Jun 9, 2016 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Jun 9, 2016 Accepting new patients
Ou Health Partners, Inc CurrentSince Nov 14, 2021 Accepting new patients
Ou Health Partners, Inc CurrentSince Nov 14, 2021 Accepting new patients
Ou Medicine Inc. Past Accepting new patients

Locations

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

1200 Everett Dr
Ofc 7514
Oklahoma City, OK 73104
Phone (405) 271-5215

900 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-2230

920 Stanton L Young Blvd
#2472
Oklahoma City, OK 73104

Interoperability endpoints

  • Direct secure messaging: sbrewer23492@ouhealth.direct-ci.net

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1372464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1588004907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 RUSSELL M PERRY AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731044018",
            "telephone_number": "405-271-5215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 EVERETT DR OFC 7514",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045047",
            "telephone_number": "405-271-5215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREWER",
        "first_name": "SARA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-29",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "T-2647",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "24384",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06827817",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.