Dwayne Lee Janzen, D. O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

1639 Issued in OK

Practice address

915 E Garriott Rd Ste a
Enid, OK 73701-6153

Phone

(580) 977-1910

Fax

(580) 237-1925

NPI assigned

Jul 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Integris Ambulatory Care Corporation

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1750333936
  Medicare reassignment NPD

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518393600000",
    "number": "1659394765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 N INDEPENDENCE AVE",
            "address_2": "280",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731125556",
            "telephone_number": "580-977-1910",
            "fax_number": "580-237-1925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 E GARRIOTT RD STE A",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737016153",
            "telephone_number": "580-977-1910",
            "fax_number": "580-237-1925"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "915 E Garriott Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Enid",
            "state": "OK",
            "postal_code": "737016153",
            "country_code": "US",
            "telephone_number": "580-977-1910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JANZEN",
        "first_name": "DWAYNE",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D. O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2018-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "34426",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "1639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100252020C",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James P. Worrell M.D., P.C.
• Katelyn James
• Eunki Jang
• Charles A Jantzen, DO
• Tasha Lee Jantzen, MA, LADC
• Kimberley Jo Jaques, PHARMACIST
• Joey Wade Jeane
• Amy Brooke Jernigan, L.P.C
• Kandice Dawn Jeske, PHARM.D.
• John a. Thomas DDS

• Family Medicine Physician in Enid, OK
• Providers in Enid, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.