Jay K Gannaway, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

12885 Issued in OK

Practice address

4833 Integris Pkwy
Suite 150
Edmond, OK 73034-8864

Phone

(405) 657-3990

Fax

(405) 471-0039

NPI assigned

Feb 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jgannaway15072@direct.integrisok.com

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.

• Integris Ambulatory Care Corporation

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1750333936
  Medicare reassignment NPD
• Deaconess Physician Services LLC

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1427017862
  NPD (past)
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500595200000",
    "number": "1609847086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 N INDEPENDENCE AVE",
            "address_2": "280",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731125556",
            "telephone_number": "405-657-3990",
            "fax_number": "405-471-0039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4833 INTEGRIS PKWY",
            "address_2": "SUITE 150",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730348864",
            "telephone_number": "405-657-3990",
            "fax_number": "405-471-0039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANNAWAY",
        "first_name": "JAY",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-01",
        "last_updated": "2017-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OK",
            "license": "12885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100129670A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ambra Gales
• Meredith Galloway
• Dan Galyean
• Ashley N Gammon
• Wendy Gamon
• Stephanie Lynn Gannaway, AU.D.,CCC-A
• Raghuvender Ganta, MD
• Lance Matthews Garber, MD
• Myrna Michelle Garbrecht, PHARMD
• Daniela Garces

• Orthopaedic Surgery Physician in Edmond, OK
• Providers in Edmond, OK by specialty
• Orthopaedic Surgery Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.