Organization Active NPI

Ageless Family Medicine LLC

Doing business as Checkup Medical Clinic

  • Family Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1710692470
Registry record updated Jan 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
AGELESS FAMILY MEDICINE LLC
Doing business as
Checkup Medical Clinic
Practice address
5300 N Meridian Ave Ste 8
Oklahoma City, OK 73112-2137
Phone
(405) 768-2121
Fax
(405) 768-2232
NPI assigned
Jan 17, 2023
Last updated
Jan 17, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2023

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

Authorized official

Name
Melanie Taponno, APRN
Title
Provider
Phone
(405) 512-4881

Specialties & licenses 1

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

Addresses

Primary practice location

5300 N Meridian Ave Ste 8
Oklahoma City, OK 73112-2137

Mailing address

1833 Olde School Rd
Edmond, OK 73012-3244
Phone (405) 512-4881

Other names 1

  • Checkup Medical Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240227001211 OK Part B Supplier - Clinic/Group Practice 0042655375 Receives reassigned benefits from 1 practitioner
Practice locations: Oklahoma City, OK

National Provider Directory

National Provider Directory

Locations

5300 N Meridian Ave
Ste 8
Oklahoma City, OK 73112
Phone (405) 768-2121

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1673913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673913600000",
    "number": "1710692470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1833 OLDE SCHOOL RD",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730123244",
            "telephone_number": "405-512-4881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 N MERIDIAN AVE STE 8",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731122137",
            "telephone_number": "405-768-2121",
            "fax_number": "405-768-2232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGELESS FAMILY MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-17",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A",
        "authorized_official_last_name": "TAPONNO",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "405-512-4881",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Checkup Medical Clinic",
            "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 Jan 17, 2023; 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.