Individual provider Active NPI

John E Grunow, MD

  • Pediatric Gastroenterology Physician
  • Oklahoma City, OK
National Provider Identifier
1679541981
Registry record updated Jan 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
11004 Issued in OK
Practice address
1200 N Phillips Ave
Suite 9500
Oklahoma City, OK 73104-4600
Phone
(405) 271-6549
Fax
(405) 271-7866
NPI assigned
Mar 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X 11004 OK Primary

Addresses

Primary practice location

1200 N Phillips Ave
Suite 9500
Oklahoma City, OK 73104-4600

Mailing address

1122 NE 13TH St
Ori236
Oklahoma City, OK 73117-1039

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20060223000430 OK Practitioner - Pediatric Medicine 0749296036 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
11004OKMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Feb 1, 2006 Accepting new patients
Ou Health Partners, Inc CurrentSince Jul 1, 2021 Accepting new patients
Ou Health Partners, Inc CurrentSince Jul 1, 2021 Accepting new patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Feb 1, 2006 Accepting new patients
Board of Regents of the University of Oklahoma - Ou Physicians Past Accepting new patients

Locations

1200 N Phillips Ave
Ste 9500
Oklahoma City, OK 73104
Phone (405) 271-5884

825 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-4864

1200 Childrens Ave
Ste 9E
Oklahoma City, OK 73104
Phone 405271800131231

825 NE 13th St
Oklahoma City, OK 73104
Phone (405) 271-1500

900 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-2230

Interoperability endpoints

  • Direct secure messaging: jgrunow22263@ouhealth.direct-ci.net

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1142035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295308800000",
    "number": "1679541981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 NE 13TH ST",
            "address_2": "ORI236",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731171039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N PHILLIPS AVE",
            "address_2": "SUITE 9500",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731044600",
            "telephone_number": "405-271-6549",
            "fax_number": "405-271-7866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUNOW",
        "first_name": "JOHN",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-11",
        "last_updated": "2011-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "OK",
            "license": "11004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.