NPIMap

Individual provider Active NPI

Spencer Tracy Zeavin, MD

  • Prison Health Clinic/Center
  • El Reno, OK
National Provider Identifier
1649670340
Registry record updated Aug 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prison Health Clinic/CenterTaxonomy code 261QP2400X
License
01041949A Issued in IN
Practice address
4205 E Highway 66
El Reno, OK 73036-9701
Phone
(405) 319-7499
Fax
(405) 319-7675
NPI assigned
Aug 29, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prison Health Clinic/Center 261QP2400X 01041949A IN Primary

Addresses

Primary practice location

4205 E Highway 66
El Reno, OK 73036-9701

Mailing address

4205 Highway 66 West
El Reno, OK 73036-1000
Phone (405) 319-7499

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01041949AINMDPrison Health Clinic/Center

Practice roles

OrganizationSpecialtyStatusNew patients
US Dept of Justice Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1409270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409270400000",
    "number": "1649670340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 HIGHWAY 66 WEST",
            "city": "EL RENO",
            "state": "OK",
            "postal_code": "730361000",
            "telephone_number": "405-319-7499",
            "fax_number": "405-319-7675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4205 E HIGHWAY 66",
            "city": "EL RENO",
            "state": "OK",
            "postal_code": "730369701",
            "telephone_number": "405-319-7499",
            "fax_number": "405-319-7675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEAVIN",
        "first_name": "SPENCER",
        "middle_name": "TRACY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-29",
        "last_updated": "2014-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Prison Health",
            "state": "IN",
            "license": "01041949A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Reno, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2014; 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.