NPIMap

Organization Active NPI

McCurtain Memorial Medical Management, Inc.

Doing business as Memorial North Health Center

  • Family Medicine Physician
  • Broken Bow, OK
National Provider Identifier
1639304181
Registry record updated Jul 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MCCURTAIN MEMORIAL MEDICAL MANAGEMENT, INC.
Doing business as
Memorial North Health Center
Practice address
510 S Park Dr
Broken Bow, OK 74728-5330
Phone
(580) 584-3449
Fax
(580) 584-3451
NPI assigned
May 27, 2009
Last updated
Jul 28, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
MCCURTAIN MEMORIAL MEDICAL MANAGEMENT, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 28, 2009

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

Authorized official

Name
Mr. Ray B Whitmore Jr.
Title
Chief Financial Officer
Phone
(580) 208-3104

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NU
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

510 S Park Dr
Broken Bow, OK 74728-5330

Mailing address

1301 E Lincoln Rd
Idabel, OK 74745-7300
Phone (580) 208-3100

Other names 1

  • Memorial North Health Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
MCC Mem Med Services16 organizations share this tax ID, including this one
Part of
MCC Mem Med Services

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1243382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248739200000",
    "number": "1639304181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 E LINCOLN RD",
            "city": "IDABEL",
            "state": "OK",
            "postal_code": "747457300",
            "telephone_number": "580-208-3100",
            "fax_number": "580-208-3199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 S PARK DR",
            "city": "BROKEN BOW",
            "state": "OK",
            "postal_code": "747285330",
            "telephone_number": "580-584-3449",
            "fax_number": "580-584-3451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCCURTAIN MEMORIAL MEDICAL MANAGEMENT, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MCCURTAIN MEMORIAL MEDICAL MANAGEMENT, INC.",
        "enumeration_date": "2009-05-27",
        "last_updated": "2009-07-28",
        "status": "A",
        "authorized_official_last_name": "WHITMORE",
        "authorized_official_first_name": "RAY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "580-208-3104",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial North Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Broken Bow, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2009; 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.