Active NPI
Kenneth Dale Priest MD PC
- Anesthesiology Physician
- Oklahoma City, OK
National Provider Identifier
1710973938
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 19107
- Legal business name
- KENNETH DALE PRIEST MD PC
- Practice address
- 3705 W Memorial Rd
Suite 302
Oklahoma City, OK 73134-1512 - Phone
- (405) 775-9350
- Fax
- (405) 775-9360
- NPI assigned
- Sep 22, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Melenie Nachimson
- Title
- Credentialing Specialist
- Phone
- (405) 775-9350
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 19107 | OK | Primary |
Addresses
Primary practice location
3705 W Memorial Rd
Suite 302
Oklahoma City, OK 73134-1512
Mailing address
PO Box 272606
Oklahoma City, OK 73137-2606
Phone (405) 775-9350
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00118819 | Other | OK | RR/MEDICARE |
| 100744690A | Medicaid | OK | |
| 4647871 | Other | OK | AETNA |
| 358460300 | Other | OK | DOL |
| DB6320 | Other | OK | MEDICARE RR GROUP |
National Provider Directory
National Provider DirectoryLocations
6201 N Santa Fe Ave
Ste 100
Oklahoma City, OK 73118
Phone (405) 272-5400
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127347200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1308182400000",
"number": "1710973938",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 272606",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731372606",
"telephone_number": "405-775-9350",
"fax_number": "405-775-9360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3705 W MEMORIAL RD",
"address_2": "SUITE 302",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731341512",
"telephone_number": "405-775-9350",
"fax_number": "405-775-9360"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KENNETH DALE PRIEST MD PC",
"organizational_subpart": "NO",
"enumeration_date": "2005-09-22",
"last_updated": "2011-06-16",
"status": "A",
"authorized_official_last_name": "NACHIMSON",
"authorized_official_first_name": "MELENIE",
"authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
"authorized_official_telephone_number": "405-775-9350"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Anesthesiology",
"state": "OK",
"license": "19107",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR/MEDICARE",
"identifier": "P00118819",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100744690A",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4647871",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DOL",
"identifier": "358460300",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RR GROUP",
"identifier": "DB6320",
"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 Jun 16, 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.