NPIMap

Organization Active NPI

Genesis Emergency Medicine Services LLC

  • Emergency Medicine Physician
  • Atoka, OK
National Provider Identifier
1669425682
Registry record updated Sep 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
GENESIS EMERGENCY MEDICINE SERVICES LLC
Practice address
1200 W Liberty Rd
Atoka, OK 74525-1621
Phone
(580) 889-3333
NPI assigned
May 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2012

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

Authorized official

Name
Frederick K Yates, MDNPI 1396791653
Title
President
Phone
(318) 524-3018

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

1200 W Liberty Rd
Atoka, OK 74525-1621

Mailing address

PO Box 11527
Daytona Beach, FL 32120-1527
Phone (386) 274-7800

Other identifiers 3

IdentifierTypeStateIssuer
159042002MedicaidAR
5F445OtherARBLUE CROSS BLUE SHIELD
DE3171OtherARRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348704000000",
    "number": "1669425682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11527",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321201527",
            "telephone_number": "386-274-7800",
            "fax_number": "386-274-7801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 W LIBERTY RD",
            "city": "ATOKA",
            "state": "OK",
            "postal_code": "745251621",
            "telephone_number": "580-889-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS EMERGENCY MEDICINE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2012-09-27",
        "status": "A",
        "authorized_official_last_name": "YATES",
        "authorized_official_first_name": "FREDERICK",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "318-524-3018",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "159042002",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5F445",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DE3171",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atoka, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2012; 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.