Individual provider Active NPI

Michael Eugene Salrin, D.O.

  • Family Medicine Physician
  • Shawnee, OK
National Provider Identifier
1699773572
Registry record updated Jan 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2770 Issued in OK
Practice address
1900 Gordon Cooper Dr
Shawnee, OK 74801-8603
Phone
(405) 878-7160
Fax
(405) 878-7149
NPI assigned
Jul 13, 2005
Last updated
Jan 14, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2770 OK Primary

Addresses

Primary practice location

1900 Gordon Cooper Dr
Shawnee, OK 74801-8603

Mailing address

11487 S 354
Earlsboro, OK 74840-9011
Phone (405) 382-0697

Other identifiers 1

IdentifierTypeStateIssuer
10050190AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2770OKMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Michael E Salrin Health Service, Inc Family Medicine Past Accepting new patients
Summit Medical Center Past Accepting new patients
Marshall County Hma LLC Family Medicine Past Accepting new patients
Midwest City Hma Physician Management, LLC Family Medicine Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294963200000",
    "number": "1699773572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11487 S 354",
            "city": "EARLSBORO",
            "state": "OK",
            "postal_code": "748409011",
            "telephone_number": "405-382-0697",
            "fax_number": "405-382-0421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 GORDON COOPER DR",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748018603",
            "telephone_number": "405-878-7160",
            "fax_number": "405-878-7149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALRIN",
        "first_name": "MICHAEL",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2011-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "2770",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10050190A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2011; 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.