NPIMap

Organization Active NPI

SSM Healthcare of Ok, Inc

  • Family Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1710272844
Registry record updated Jul 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SSM HEALTHCARE OF OK, INC
Practice address
8241 S Walker Ave
Suite 100
Oklahoma City, OK 73139-9401
Phone
(405) 632-6025
Fax
(405) 632-4506
NPI assigned
Jun 16, 2011
Organization subpart
Yes
Parent organization
SSM HEALTHCARE OF OK, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 8, 2011

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

Authorized official

Name
Ms. Crystal L Pena
Title
Insurance Credentialing Specialist
Phone
(405) 272-7452

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

8241 S Walker Ave
Suite 100
Oklahoma City, OK 73139-9401

Mailing address

PO Box 269064
Oklahoma City, OK 73126-9064
Phone (405) 272-7452

Other names 1

  • St Anthony Family Medicine South Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Marilyn Doughtery MD56 organizations share this tax ID, including this one
Part of
Marilyn Doughtery MD

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1308182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310083200000",
    "number": "1710272844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 269064",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731269064",
            "telephone_number": "405-272-7452",
            "fax_number": "405-272-7937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8241 S WALKER AVE",
            "address_2": "SUITE 100",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731399401",
            "telephone_number": "405-632-6025",
            "fax_number": "405-632-4506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SSM HEALTHCARE OF OK, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SSM HEALTHCARE OF OK, INC",
        "enumeration_date": "2011-06-16",
        "last_updated": "2011-07-08",
        "status": "A",
        "authorized_official_last_name": "PENA",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "INSURANCE CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "405-272-7452",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Anthony Family Medicine South",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 8, 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.