Edmond Physician Services LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

EDMOND PHYSICIAN SERVICES LLC

Practice address

105 S Bryant Ave Ste 105
Edmond, OK 73034-6330

Phone

(405) 715-3102

NPI assigned

Jun 8, 2006

Organization subpart

No

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

Authorized official

Name

Stephanie Jones

Title

Director of Patient Accounting

Phone

(405) 271-8132

Specialties & licenses 1

Addresses

Other identifiers 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Ou Medicine Inc.

  • Psychiatric Hospital Unit
  • Edmond, OK
  • NPI 1609390111

  Member Of

  NPD member

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Timothy L Grode, MD

  • Pulmonary Disease Physician
  • Oklahoma City, OK
  • NPI 1639164163
  NPD (past)
• Kathleen E Mason-Morton, PA

  • Physician Assistant
  • Edmond, OK
  • NPI 1558355180
  NPD (past)

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552262400000",
    "number": "1629018429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 744503",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303744503",
            "telephone_number": "405-271-8132",
            "fax_number": "405-271-5006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 S BRYANT AVE STE 105",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730346330",
            "telephone_number": "405-715-3102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDMOND PHYSICIAN SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-08",
        "last_updated": "2019-03-11",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "DIRECTOR OF PATIENT ACCOUNTING",
        "authorized_official_telephone_number": "405-271-8132"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200045590A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edmond MRI LLC (Renaissance MRI)
• Edmond Optical Shop, Inc.
• Edmond Oral and Maxillofacial Surgery
• Edmond Pediatric and Teen Dentistry
• Edmond Pediatrics
• Edmond Podiatry Associates LLC (Central Oklahoma Foot and Ankle Center of Edmond)
• Edmond Premier Drug LLC
• Edmond Primary Care LLC
• Edmond Public Schools
• Edmond Regional Eye Associates Inc

• Internal Medicine Physician in Edmond, OK
• Providers in Edmond, OK by specialty
• Internal Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2019; 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.