NPIMap

Individual provider Active NPI

Jamie Lynn Gore, D.O.

  • Family Medicine Physician
  • Woodward, OK
National Provider Identifier
1730113788
Registry record updated Oct 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4298 Issued in OK
Practice address
1611 Main St Ste 102
Woodward, OK 73801-3064
Phone
(580) 254-8192
Fax
(580) 256-3624
NPI assigned
Jul 10, 2006
Last updated
Oct 20, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4298 OK Primary

Addresses

Primary practice location

1611 Main St Ste 102
Woodward, OK 73801-3064

Mailing address

1611 Main St Ste 102
Woodward, OK 73801-3064
Phone (580) 254-8192

Other practice location 1

1101 Hillcrest Dr
Woodward, OK 73801-3027
Phone (580) 254-8192

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jamie.gore.1@1601.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060909000032 OK Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 0840294625 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Osteopathic Manipulative Medicine
Education
Oklahoma State University College of Osteopathic Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integris Ambulatory Care CorporationGroup PAC ID 2365408465, 687 clinicians

Practice addresses (Care Compare)

3400 NW Expressway
Suite 500
Oklahoma City, OK 73112-4492
Phone (405) 945-4589

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions26
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
4298OKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Integris Ambulatory Care Corporation Family Medicine CurrentSince Nov 6, 2023 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Integris Ambulatory Care C Orporation Family Medicine Past Accepting new patients
Summit Medical Center Past Accepting new patients
Integris Health Woodward Hospital Inc Past Accepting new patients
Integris Health Woodward Hospital Inc Past Accepting new patients

Locations

502 S Main St
Leedey, OK 73654
Phone (580) 488-2055

3400 NW Expressway
Ste 500
Oklahoma City, OK 73112
Phone (405) 945-4589

900 17th St
Woodward, OK 73801
Phone (405) 610-4411

Interoperability endpoints

  • Direct secure messaging: jamie.gore.1@1601.direct.athenahealth.com
  • Direct secure messaging: jgore485495@direct.integrisok.com

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Integris Health Medical GroupWoodward, OK, CCN 373475 Rural health clinic Contracted Managing Employee
Operational/Managerial Control		 Nov 1, 2023
Nov 1, 2023
Integris Health Medical GroupWoodward, OK, CCN 373474 Rural health clinic Contracted Managing Employee
Operational/Managerial Control		 Nov 1, 2023
Nov 1, 2023

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1730113788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 MAIN ST STE 102",
            "city": "WOODWARD",
            "state": "OK",
            "postal_code": "738013064",
            "telephone_number": "580-254-8192",
            "fax_number": "580-256-3624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 MAIN ST STE 102",
            "city": "WOODWARD",
            "state": "OK",
            "postal_code": "738013064",
            "telephone_number": "580-254-8192",
            "fax_number": "580-256-3624"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 Hillcrest Dr",
            "address_purpose": "LOCATION",
            "city": "Woodward",
            "state": "OK",
            "postal_code": "738013027",
            "country_code": "US",
            "telephone_number": "580-254-8192",
            "fax_number": "580-256-3624",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORE",
        "first_name": "JAMIE",
        "middle_name": "LYNN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "4298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jamie.gore.1@1601.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR Direct Address",
            "address_1": "1611 Main St Ste 102",
            "city": "Woodward",
            "state": "OK",
            "country_code": "US",
            "postal_code": "738013064",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Woodward, OK

Sources for this page

Verify at the official NPI Registry.