Organization Active NPI

Tim R. Love, M.D., P.C.

  • Plastic Surgery Physician
  • Oklahoma City, OK
National Provider Identifier
1679741573
Registry record updated Jul 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
14771 Issued in OK
Legal business name
TIM R. LOVE, M.D., P.C.
Practice address
11101 Hefner Pointe Dr Ste 104
Oklahoma City, OK 73120-5054
Phone
(405) 751-5683
Fax
(405) 751-9500
NPI assigned
Feb 13, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2008

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

Authorized official

Name
Tim R. Love, M.D.NPI 1043234032
Title
President
Phone
(405) 751-5683

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X 14771 OK Primary

Addresses

Primary practice location

11101 Hefner Pointe Dr Ste 104
Oklahoma City, OK 73120-5054

Mailing address

11101 Hefner Pointe Dr Ste 104
Oklahoma City, OK 73120-5054
Phone (405) 751-5683

Other identifiers 1

IdentifierTypeStateIssuer
446545991002OtherOKBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080501000412 OK Part B Supplier - Clinic/Group Practice 3779662754 Receives reassigned benefits from 1 practitioner
Practice locations: Oklahoma City, OK

National Provider Directory

National Provider Directory

Locations

11101 Hefner Pointe Dr
Ste 104
Oklahoma City, OK 73120
Phone (405) 751-5683

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": "1202860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216857600000",
    "number": "1679741573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11101 HEFNER POINTE DR STE 104",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731205054",
            "telephone_number": "405-751-5683",
            "fax_number": "405-751-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11101 HEFNER POINTE DR STE 104",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731205054",
            "telephone_number": "405-751-5683",
            "fax_number": "405-751-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIM R. LOVE, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-13",
        "last_updated": "2008-07-24",
        "status": "A",
        "authorized_official_last_name": "LOVE",
        "authorized_official_first_name": "TIM",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "405-751-5683",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "OK",
            "license": "14771",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "446545991002",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.