NPIMap

Organization Active NPI

Outpatient Surgical Center of Ponca City, LLC

  • Ambulatory Surgical Clinic/Center
  • Ponca City, OK
National Provider Identifier
1659337194
Registry record updated Nov 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
0021 Issued in OK
Legal business name
OUTPATIENT SURGICAL CENTER OF PONCA CITY, LLC
Practice address
400 Fairview Ave
Suite 50
Ponca City, OK 74601-1920
Phone
(580) 762-0695
Fax
(580) 765-9406
NPI assigned
Apr 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2010

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

Authorized official

Name
Mrs. Steffi Moon Cowan
Title
Administrator
Phone
(580) 762-0695

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 0021 OK Primary

Addresses

Primary practice location

400 Fairview Ave
Suite 50
Ponca City, OK 74601-1920

Mailing address

400 Fairview Ave
Suite 50
Ponca City, OK 74601-1920
Phone (580) 762-0695

Other identifiers 1

IdentifierTypeStateIssuer
200037990AMedicaidOK

National Provider Directory

National Provider Directory

Locations

400 Fairview Ave
Ste 50
Ponca City, OK 74601
Phone (580) 762-0695

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288569600000",
    "number": "1659337194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 FAIRVIEW AVE",
            "address_2": "SUITE 50",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746011920",
            "telephone_number": "580-762-0695",
            "fax_number": "580-765-9406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 FAIRVIEW AVE",
            "address_2": "SUITE 50",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746011920",
            "telephone_number": "580-762-0695",
            "fax_number": "580-765-9406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUTPATIENT SURGICAL CENTER OF PONCA CITY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-25",
        "last_updated": "2010-11-01",
        "status": "A",
        "authorized_official_last_name": "COWAN",
        "authorized_official_first_name": "STEFFI",
        "authorized_official_middle_name": "MOON",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "580-762-0695",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "OK",
            "license": "0021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200037990A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponca City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2010; 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.