NPIMap

Organization Active NPI

Southern Oklahoma Surgical Center Inc

  • Ambulatory Surgical Clinic/Center
  • Ardmore, OK
National Provider Identifier
1699767210
Registry record updated Nov 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
0023 Issued in OK
Legal business name
SOUTHERN OKLAHOMA SURGICAL CENTER INC
Practice address
2412 N Commerce St
Ardmore, OK 73401-1356
Phone
(580) 226-5000
Fax
(580) 226-5035
NPI assigned
Aug 19, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2008

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

Authorized official

Name
Christy Morris, RN
Title
Administrator
Phone
(580) 226-5000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 0023 OK Primary

Addresses

Primary practice location

2412 N Commerce St
Ardmore, OK 73401-1356

Mailing address

PO Box 5978
Ardmore, OK 73403-0978
Phone (580) 226-5000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040109000879 OK Part B Supplier - Clinic/Group Practice 4082514708 Receives reassigned benefits from 10 practitioners
Practice locations: Ardmore, OK

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Southern Oklahoma Surgi2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

2412 N Commerce St
Ardmore, OK 73401
Phone (580) 226-5000

Practitioners & affiliated clinicians

Practitioners 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226966400000",
    "number": "1699767210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5978",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734030978",
            "telephone_number": "580-226-5000",
            "fax_number": "580-226-5035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2412 N COMMERCE ST",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734011356",
            "telephone_number": "580-226-5000",
            "fax_number": "580-226-5035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN OKLAHOMA SURGICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-19",
        "last_updated": "2008-11-18",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "CHRISTY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "580-226-5000",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "OK",
            "license": "0023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ardmore, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.