Individual provider Active NPI

John Mark Gilchrist, M.D.

  • Otolaryngology Physician
  • Edmond, OK
National Provider Identifier
1609834142
Registry record updated Jun 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
16187 Issued in OK
Practice address
3824 S Boulevard
Suite 160
Edmond, OK 73013-5778
Phone
(405) 562-1810
Fax
(405) 562-1816
NPI assigned
May 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 16187 OK
Otolaryngology Physician 207Y00000X 16187 OK Primary

Addresses

Primary practice location

3824 S Boulevard
Suite 160
Edmond, OK 73013-5778

Mailing address

3033 NW 63Rd St
Suite 152
Oklahoma City, OK 73116-3634
Phone (405) 755-6651

Other identifiers 1

IdentifierTypeStateIssuer
100090320 AMedicaidOK

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
I20050419000260 OK Practitioner - Otolaryngology 2466419239 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Oklahoma College of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oklahoma Otolaryngology Associates LLCGroup PAC ID 9739136102, 15 clinicians

Practice addresses (Care Compare)

3824 S Boulevard
Suite 160
Edmond, OK 73013-5780
Phone (405) 562-1810

Hospital & facility affiliations

  • Integris Health Edmond Hospital Hospital, Edmond, OK, CCN 370236

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Oklahoma Otolaryngology Associates, LLC Specialist CurrentSince Jan 1, 2003 Accepting new patients
Sleep Solutions Northwest, LLC PastSince Jul 1, 2009 Accepting new patients
Summit Medical Center Past Accepting new patients
Oklahoma Otolaryngology Hearing Center Inc PastSince Jan 30, 2013 Accepting new patients

Locations

3824 S Boulevard
Ste 160
Edmond, OK 73013
Phone (405) 348-2424

3650 W Rock Creek Rd
Norman, OK 73072
Phone (405) 364-2666

4200 W Memorial Rd
Ste 606
Oklahoma City, OK 73120
Phone (405) 755-1930

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464739200000",
    "number": "1609834142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3033 NW 63RD ST",
            "address_2": "SUITE 152",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731163634",
            "telephone_number": "405-755-6651",
            "fax_number": "405-755-2795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3824 S BOULEVARD",
            "address_2": "SUITE 160",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730135778",
            "telephone_number": "405-562-1810",
            "fax_number": "405-562-1816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILCHRIST",
        "first_name": "JOHN",
        "middle_name": "MARK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2016-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OK",
            "license": "16187",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OK",
            "license": "16187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100090320 A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

Verify at the official NPI Registry.