NPIMap

Organization Active NPI

Stillwater Medical Center Authority

  • Neurology Physician
  • Stillwater, OK
National Provider Identifier
1679588552
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
4112 Issued in OK
Legal business name
STILLWATER MEDICAL CENTER AUTHORITY
Practice address
1301 W 6TH Ave
Suite 108
Stillwater, OK 74074-4375
Phone
(405) 533-2667
NPI assigned
Jul 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Karen L Hendren
Title
Cfo
Phone
(405) 742-5729

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X 4112 OK Primary

Addresses

Primary practice location

1301 W 6TH Ave
Suite 108
Stillwater, OK 74074-4375

Mailing address

1323 W 6TH Ave
Box 2408
Stillwater, OK 74074-4306
Phone (405) 533-2667

Other names 1

  • Comprehensive Neurology Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Cimarron Medical Supply28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

Organizations that report the same tax identification number in the National Provider Directory.

View all 27

Locations

1323 W 6th Ave
#2408
Stillwater, OK 74074
Phone (405) 742-5458

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679588552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1323 W 6TH AVE",
            "address_2": "BOX 2408",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740744306",
            "telephone_number": "405-533-2667",
            "fax_number": "405-742-4990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 W 6TH AVE",
            "address_2": "SUITE 108",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740744375",
            "telephone_number": "405-533-2667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STILLWATER MEDICAL CENTER AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HENDREN",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "405-742-5729",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OK",
            "license": "4112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Comprehensive Neurology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stillwater, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.