Active NPI
Anthony Wayne Waldroup, MD, MPH
- Family Medicine Physician
- Ada, OK
National Provider Identifier
1720041924
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 20220
- Practice address
- 530 N Monte Vista St Ste a
Ada, OK 74820-4675 - Phone
- (580) 310-9510
- Fax
- (580) 436-4447
- NPI assigned
- Apr 10, 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Preventive Medicine/Occupational Environmental Medicine Physician | 2083P0500X | 20220 | OK | |
| Family Medicine Physician | 207Q00000X | 20220 | OK | Primary |
| Aerospace Medicine Physician | 2083A0100X | 20220 | OK |
Addresses
Primary practice location
530 N Monte Vista St Ste a
Ada, OK 74820-4675
Mailing address
530 N Monte Vista St Ste a
Ada, OK 74820-4675
Phone (580) 310-9510
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Oklahoma College of Medicine, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1921 Stonecipher Dr
Ada, OK 74820-3439
Phone (580) 436-3980
530 N Monte Vista a
Mercy Clinic Primary Care Ada Monte Vista
Ada, OK 74820-4675
Phone (580) 310-9510
Hospital & facility affiliations
- Chickasaw Nation Medical Center
- Mercy Hospital Ada
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal or shaving of skin growth | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20220 | OK | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Clinic Oklahoma Communities | Family Medicine | Current | Accepting new patients |
| Durant Hma Inc. | Past | Accepting new patients | |
| Mercy Hospital Oklahoma City, Inc | Past | Accepting new patients |
Locations
530 N Monte Vista St
Ste A
Ada, OK 74820
Phone (580) 310-9510
4300 McAuley Blvd
Oklahoma City, OK 73120
Phone (405) 936-5455
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 and National Provider Directory roles.
-
- Family Medicine Physician
- Oklahoma City, OK
- NPI 1386874550
-
- Internal Medicine Physician
- Durant, OK
- NPI 1083667075
-
- Diagnostic Radiology Physician
- Yukon, OK
- NPI 1730326406
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Ada, OK
- NPI 1255364923
-
- Primary Care Clinic/Center
- Tishomingo, OK
- NPI 1649330242
Hospital
-
- Primary Care Clinic/Center
- Ada, OK
- NPI 1962563148
Hospital
-
- General Acute Care Hospital
- Ada, OK
- NPI 1952643306
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144627200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741651200000",
"number": "1720041924",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "530 N MONTE VISTA ST STE A",
"city": "ADA",
"state": "OK",
"postal_code": "748204675",
"telephone_number": "580-310-9510",
"fax_number": "580-436-4447"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "530 N MONTE VISTA ST STE A",
"city": "ADA",
"state": "OK",
"postal_code": "748204675",
"telephone_number": "580-310-9510",
"fax_number": "580-436-4447"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALDROUP",
"first_name": "ANTHONY",
"middle_name": "WAYNE",
"name_prefix": "Dr.",
"credential": "MD, MPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-10",
"last_updated": "2025-03-11",
"certification_date": "2025-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "2083P0500X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
"state": "OK",
"license": "20220",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OK",
"license": "20220",
"primary": true
},
{
"code": "2083A0100X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Aerospace Medicine",
"state": "OK",
"license": "20220",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ada, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.