NPIMap

Individual provider Active NPI

Nizar Ghazi Al-Nimri, MD

  • Hospitalist Physician
  • Altus, OK
National Provider Identifier
1679738678
Registry record updated Nov 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
41197 Issued in OK
Practice address
1200 E Pecan St
Altus, OK 73521-6192
Phone
(580) 379-5000
Fax
(580) 379-5999
NPI assigned
Jul 20, 2008
Last updated
Nov 21, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2009037641 MO
Internal Medicine Physician 207R00000X 41197 OK
Hospitalist Physician 208M00000X 2009037641 MO
Hospitalist Physician 208M00000X 41197 OK Primary

Addresses

Primary practice location

1200 E Pecan St
Altus, OK 73521-6192

Mailing address

1200 E Pecan St
Altus, OK 73521-6192
Phone (580) 379-5000

Other identifiers 1

IdentifierTypeStateIssuer
200306030AMedicaidOK

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@direct.jcmh.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, OK2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100327000530 MO Practitioner - HospitalistPractitioner - Internal Medicine 7113053281 Reassigns benefits to 3 organizations
I20230822000397 OK Practitioner - HospitalistPractitioner - Pulmonary Disease 7113053281 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Pulmonary Disease
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jackson County Memorial Hospital AuthorityGroup PAC ID 1759293178, shared by 9 NPIs, 46 clinicians

Practice addresses (Care Compare)

400 E Chestnut St
Hollis, OK 73550-2030
Phone (580) 688-3363

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2009037641MOMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Physicians of Illinois, LLC Internal Medicine CurrentSince Jul 4, 2017 Accepting new patients
Jackson County Memorial Hospital Authority CurrentSince Jul 24, 2023 Accepting new patients
Galen Inpatient Physicians PC Hospitalist CurrentSince Nov 23, 2019 Accepting new patients
SSM Health Care St Louis CurrentSince Sep 15, 2019 Accepting new patients
Jackson County Memorial Hospital Authority CurrentSince Jul 24, 2023 Accepting new patients
Galen Inpatient Physicians PC. Internal Medicine CurrentSince Nov 23, 2019 Accepting new patients
Apogee Medical Group Missouri Inc Internal Medicine Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189

12303 De Paul Dr
Bridgeton, MO 63044
Phone (314) 344-6360

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

6420 Clayton Rd
Saint Louis, MO 63117
Phone (314) 768-8442

1200 E Pecan St
Altus, OK 73521
Phone (580) 379-5000

205 S Park Ln
Ste 210
Altus, OK 73521
Phone (580) 379-6650

400 E Chestnut St
Hollis, OK 73550
Phone (580) 471-0971

Interoperability endpoints

  • Direct secure messaging: him@direct.jcmh.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1216512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700524800000",
    "number": "1679738678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 E PECAN ST",
            "city": "ALTUS",
            "state": "OK",
            "postal_code": "735216192",
            "telephone_number": "580-379-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E PECAN ST",
            "city": "ALTUS",
            "state": "OK",
            "postal_code": "735216192",
            "telephone_number": "580-379-5000",
            "fax_number": "580-379-5999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL-NIMRI",
        "first_name": "NIZAR",
        "middle_name": "GHAZI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-20",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2009037641",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "41197",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MO",
            "license": "2009037641",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OK",
            "license": "41197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200306030A",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@direct.jcmh.com",
            "affiliation": "N",
            "address_1": "1200 E Pecan St",
            "city": "Altus",
            "state": "OK",
            "country_code": "US",
            "postal_code": "735216192",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Altus, OK

Sources for this page

Verify at the official NPI Registry.