NPIMap

Individual provider Active NPI

John P Agent, DO

  • Internal Medicine Physician
  • Sallisaw, OK
National Provider Identifier
1649217191
Registry record updated Dec 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
3341 Issued in OK
Practice address
1015 E Choctaw Ave
Sallisaw, OK 74955-5011
Phone
(918) 774-0034
Fax
(918) 774-0650
NPI assigned
Jun 1, 2006
Last updated
Dec 20, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X E-1152 AR
Internal Medicine Physician 207R00000X 3341 OK Primary

Addresses

Primary practice location

1015 E Choctaw Ave
Sallisaw, OK 74955-5011

Mailing address

PO Box 776075
Chicago, IL 60677-6075
Phone (918) 774-0034

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, OK2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20091216000595 AR Practitioner - Internal Medicine 2365582624 Reassigns benefits to 4 organizations
I20150624002224 OK Practitioner - Internal Medicine 2365582624 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Oklahoma State University College of Osteopathic Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Fort Smith CommunitiesGroup PAC ID 3870668510, shared by 4 NPIs, 361 clinicians
Fands Physical Therapy, IncGroup PAC ID 7810898459, 217 clinicians

Practice addresses (Care Compare)

1015 E Choctaw Ave
Mercy Clinic Primary Care Sallisaw
Sallisaw, OK 74955-5011
Phone (918) 774-0034

1414 Hwy 71 N
Alma, AR 72921-4723
Phone (479) 632-0321

3501 We Knight Dr
Fort Smith, AR 72903-6254
Phone (479) 709-6700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-1152ARMDInternal Medicine Physician
3341OKMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Fort Smith Communities CurrentSince Oct 2, 2017 Accepting new patients
Prime Physicians LLC CurrentSince Jun 1, 2023 Accepting new patients
Mercy Clinic Fort Smith Communities CurrentSince Jul 28, 2019 Accepting new patients
Baptist Health Services Internal Medicine CurrentSince Dec 1, 2019 Accepting new patients
Mercy Clinic Fort Smith Communities CurrentSince Oct 2, 2017 Accepting new patients
Mercy Clinic Fort Smith Communities CurrentSince Nov 1, 2017 Accepting new patients
Baptist Health Services Current Accepting new patients
Ahs Oklahoma Physician Group LLC Internal Medicine Past Accepting new patients
Sequoyah County City of Sallisaw Hospital Authority Past Accepting new patients

Locations

1001 Towson Ave
Fort Smith, AR 72901
Phone (479) 441-3980

1120 Lexington Ave
Fort Smith, AR 72901
Phone (479) 709-7120

1500 Dodson Ave
Ste 285B
Fort Smith, AR 72901
Phone (479) 709-7025

3501 We Knight Dr
Fort Smith, AR 72903
Phone (479) 709-6700

6801 Rogers Ave
Fort Smith, AR 72903
Phone (479) 314-6000

7001 Rogers Ave
Fort Smith, AR 72903
Phone (479) 478-3510

7001 Rogers Ave
Ste 200
Fort Smith, AR 72903
Phone (479) 314-4620

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

2800 Fayetteville Rd
Van Buren, AR 72956
Phone (479) 314-4000

1015 E Choctaw Ave
Sallisaw, OK 74955
Phone (918) 774-0034

213 E Redwood Ave
Sallisaw, OK 74955
Phone (918) 774-1100

Interoperability endpoints

  • FHIR API: https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4
  • Direct secure messaging: jagent134915@directc.mercy.net
  • Direct secure messaging: jagent241742@direct.baptist-healthar.org

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545264000000",
    "number": "1649217191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776075",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776075",
            "telephone_number": "918-774-0034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 E CHOCTAW AVE",
            "city": "SALLISAW",
            "state": "OK",
            "postal_code": "749555011",
            "telephone_number": "918-774-0034",
            "fax_number": "918-774-0650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGENT",
        "first_name": "JOHN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2018-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E-1152",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "3341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sallisaw, OK

Sources for this page

Verify at the official NPI Registry.