Individual provider Active NPI

Carlan Kent Yates, MD

  • Orthopaedic Surgery Physician
  • Oklahoma City, OK
National Provider Identifier
1679572416
Registry record updated Aug 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
13887 Issued in OK
Practice address
9600 Broadway Ext
Oklahoma City, OK 73114-7408
Phone
(405) 230-9000
Fax
(405) 230-9421
NPI assigned
Jul 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 13887 OK
Orthopaedic Surgery Physician 207X00000X 13887 OK Primary

Addresses

Primary practice location

9600 Broadway Ext
Oklahoma City, OK 73114-7408

Mailing address

9600 Broadway Ext
Oklahoma City, OK 73114-7408
Phone (405) 230-9000

Other identifiers 2

IdentifierTypeStateIssuer
200040195OtherOKRAILROAD MEDICARE
100112760AMedicaidOK

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
I20091208000658 OK Practitioner - Orthopedic SurgeryPractitioner - Other (Physician) 4688615719 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13887OKMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McBride Clinic Orthopedic Hospital, LLC Orthopaedic Surgery CurrentSince Jan 1, 2006 Accepting new patients
McBride Clinic Inc Orthopaedic Surgery Past Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

400 N Bryant Ave
Edmond, OK 73034
Phone (405) 230-9200

1110 N Lee Ave
Oklahoma City, OK 73103
Phone (405) 232-0341

9600 Broadway Ext
Oklahoma City, OK 73114
Phone (405) 486-2100

Organizations & group practices 4

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": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565308800000",
    "number": "1679572416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9600 BROADWAY EXT",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731147408",
            "telephone_number": "405-230-9000",
            "fax_number": "405-230-9157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9600 BROADWAY EXT",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731147408",
            "telephone_number": "405-230-9000",
            "fax_number": "405-230-9421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YATES",
        "first_name": "CARLAN",
        "middle_name": "KENT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-14",
        "last_updated": "2019-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "OK",
            "license": "13887",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OK",
            "license": "13887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "200040195",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100112760A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.