Individual provider Active NPI

John P Ross, MD

  • Urology Physician
  • Edmond, OK
National Provider Identifier
1679535470
Registry record updated Apr 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
13842 Issued in OK
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

Updated by the provider on Apr 3, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
$$$$$$$$$OtherOKBCBS
100130030AMedicaidOK

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

LicenseStateTypeSpecialty
13842OKMDUrology 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.

Verify at the official NPI Registry.