Active NPI
John P Ross, MD
- Urology Physician
- Edmond, OK
National Provider Identifier
1679535470
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 13842
- Practice address
- 14104 N. Eastern Ave. Ste. E
Edmond, OK 73013 - Phone
- (405) 340-1279
- Fax
- (405) 216-5089
- NPI assigned
- Apr 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | MD-45914 | IA | |
| Urology Physician | 208800000X | 13842 | OK | Primary |
Addresses
Primary practice location
14104 N. Eastern Ave. Ste. E
Edmond, OK 73013
Mailing address
1211 N Shartel Ave
Ste 200
Oklahoma City, OK 73103-2425
Phone (405) 235-8008
Other practice location 1
5950 University Ave Ste 341
West Des Moines, IA 50266-8289
Phone (515) 875-9800
Other practice location 2
1211 N Shartel Ave
Suite 300
Oklahoma City, OK 73103-2400
Phone (405) 235-8008
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| $$$$$$$$$ | Other | OK | BCBS |
| 100130030A | Medicaid | OK |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13842 | OK | MD | Urology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554249600000",
"number": "1679535470",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1211 N SHARTEL AVE",
"address_2": "STE 200",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731032425",
"telephone_number": "405-235-8008",
"fax_number": "405-239-2403"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14104 N. EASTERN AVE. STE. E",
"city": "EDMOND",
"state": "OK",
"postal_code": "73013",
"telephone_number": "405-340-1279",
"fax_number": "405-216-5089"
}
],
"practiceLocations": [
{
"address_1": "5950 University Ave Ste 341",
"address_purpose": "LOCATION",
"city": "West Des Moines",
"state": "IA",
"postal_code": "502668289",
"country_code": "US",
"telephone_number": "515-875-9800",
"fax_number": "515-875-9804",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1211 N Shartel Ave",
"address_2": "Suite 300",
"address_purpose": "LOCATION",
"city": "Oklahoma City",
"state": "OK",
"postal_code": "731032400",
"country_code": "US",
"telephone_number": "405-235-8008",
"fax_number": "405-239-2403",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROSS",
"first_name": "JOHN",
"middle_name": "P",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-05",
"last_updated": "2019-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "IA",
"license": "MD-45914",
"primary": false
},
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "OK",
"license": "13842",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "$$$$$$$$$",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100130030A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Edmond, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.