Individual provider Active NPI

Susan J Jones, D.O.

  • Family Medicine Physician
  • Wynnewood, OK
National Provider Identifier
1730155904
Registry record updated Jun 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2341 Issued in OK
Practice address
1202 E Robert S Kerr Blvd
Wynnewood, OK 73098-7822
Phone
(405) 665-2424
Fax
(405) 665-2466
NPI assigned
Feb 27, 2006
Last updated
Jun 30, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2011

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 2341 OK Primary

Addresses

Primary practice location

1202 E Robert S Kerr Blvd
Wynnewood, OK 73098-7822

Mailing address

1202 E Robert S Kerr Blvd
Wynnewood, OK 73098-7822
Phone (405) 665-2424

Other identifiers 1

IdentifierTypeStateIssuer
100124310AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Oklahoma State University College of Osteopathic Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Central Medical and Resource Center IncGroup PAC ID 9032200084, 17 clinicians

Practice addresses (Care Compare)

216 S Main St
Lindsay, OK 73052-5634
Phone (405) 756-1414

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2341OKMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Plains Medical Center Inc CurrentSince Feb 1, 2019 Accepting new patients
Southern Plains Medical Center Inc CurrentSince Feb 1, 2019 Accepting new patients
Southern Plains Medical Center Inc Current Accepting new patients
State of Oklahoma Past Accepting new patients
Washita Valley Living Center, Inc Past Accepting new patients
Garvin County Occupational & Family Medicine LLC Past Accepting new patients

Locations

1104 E Central Blvd
Anadarko, OK 73005
Phone (405) 247-6685

2222 W Iowa Ave
Chickasha, OK 73018
Phone (405) 592-3937

504 Williams
Maysville, OK 73057
Phone (405) 867-4404

100 Valley Dr
Pauls Valley, OK 73075
Phone (405) 238-5501

106 Burr Ave
Pauls Valley, OK 73075
Phone (405) 238-4633

200 Melville Dr
Pauls Valley, OK 73075
Phone (405) 238-5555

Organizations & group practices 7

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 2

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

NPI Registry JSON

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309392000000",
    "number": "1730155904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 E ROBERT S KERR BLVD",
            "city": "WYNNEWOOD",
            "state": "OK",
            "postal_code": "730987822",
            "telephone_number": "405-665-2424",
            "fax_number": "405-665-2466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 E ROBERT S KERR BLVD",
            "city": "WYNNEWOOD",
            "state": "OK",
            "postal_code": "730987822",
            "telephone_number": "405-665-2424",
            "fax_number": "405-665-2466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "SUSAN",
        "middle_name": "J",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-27",
        "last_updated": "2011-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "2341",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100124310A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wynnewood, OK

Sources for this page

Verify at the official NPI Registry.