Grady Memorial Hospital

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

GRADY MEMORIAL HOSPITAL

Doing business as

Five Oaks Family Medical Clinic DME

Practice address

2100 W Iowa Ave Ste a
Chickasha, OK 73018-2736

Phone

(405) 224-2100

Fax

(405) 779-2310

NPI assigned

Jul 27, 2006

Last updated

Mar 17, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Warren Kean Spellman

Title

Ceo

Phone

(405) 779-2150

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Five Oaks Family Medical Clinic DME Doing business as

Locations

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1619991098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 W IOWA AVE STE A",
            "city": "CHICKASHA",
            "state": "OK",
            "postal_code": "730182736",
            "telephone_number": "405-224-2100",
            "fax_number": "405-779-2310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 W IOWA AVE STE A",
            "city": "CHICKASHA",
            "state": "OK",
            "postal_code": "730182736",
            "telephone_number": "405-224-2100",
            "fax_number": "405-779-2310"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 W Iowa Ave",
            "address_purpose": "LOCATION",
            "city": "Chickasha",
            "state": "OK",
            "postal_code": "730182736",
            "country_code": "US",
            "telephone_number": "405-224-2100",
            "fax_number": "405-779-2346",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GRADY MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "SPELLMAN",
        "authorized_official_first_name": "WARREN",
        "authorized_official_middle_name": "KEAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "405-779-2150"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100700820E",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Five Oaks Family Medical Clinic DME",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Xavier Lopez Gonzalez, M.D.
• Edwina Goombi
• Grady Memorial Hospital
• Grady Memorial Hospital (Five Oaks Family Medical Clinic)
• Grady Memorial Hospital
• Grady Memorial Hospital (Five Oaks Medical Group)
• Grady Memorial Hospital (FOMG Clinical Medical Laboratory)
• Grady Memorial Hospital (Anesthesia Services)
• Grady Memorial Hospital
• Grady Memorial Hospital (Professional Medical Services)

• Durable Medical Equipment & Medical Supplies in Chickasha, OK
• Providers in Chickasha, OK by specialty
• Durable Medical Equipment & Medical Supplies in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.