Active NPI
Paul D Addison, MD
- Anatomic Pathology & Clinical Pathology Physician
- Oklahoma City, OK
National Provider Identifier
1700814845
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 17535
- Practice address
- 1000 N Lee Ave
Oklahoma City, OK 73102-1036 - Phone
- (405) 272-7041
- NPI assigned
- Jun 29, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 17535 | OK | Primary |
Addresses
Primary practice location
1000 N Lee Ave
Oklahoma City, OK 73102-1036
Mailing address
PO Box 26303
Oklahoma City, OK 73126-0303
Phone (405) 947-8584
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4282200 | Other | OK | AETNA |
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17535 | OK | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208476800000",
"number": "1700814845",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 26303",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731260303",
"telephone_number": "405-947-8584",
"fax_number": "405-948-6507"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 N LEE AVE",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731021036",
"telephone_number": "405-272-7041"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADDISON",
"first_name": "PAUL",
"middle_name": "D",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-29",
"last_updated": "2008-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "OK",
"license": "17535",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4282200",
"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 Apr 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.