NPIMap

Organization Active NPI

Jane Phillips Memorial Medical Center, Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Bartlesville, OK
National Provider Identifier
1730223090
Registry record updated May 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
2190 Issued in OK
Legal business name
JANE PHILLIPS MEMORIAL MEDICAL CENTER, INC.
Doing business as
Jane Phillips Dialysis Center
Practice address
3500 State St
Bartlesville, OK 74006-2932
Phone
(918) 333-7200
Fax
(918) 331-1447
NPI assigned
Feb 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2008

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

Authorized official

Name
Mike A. Moore
Title
Cfo
Phone
(918) 331-1644

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 2190 OK Primary

Addresses

Primary practice location

3500 State St
Bartlesville, OK 74006-2932

Mailing address

3500 State St
Bartlesville, OK 74006-2932
Phone (918) 333-7200

Other identifiers 1

IdentifierTypeStateIssuer
100699490 IMedicaidOK

Other names 1

  • Jane Phillips Dialysis Center Doing business as

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211328000000",
    "number": "1730223090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 STATE ST",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "740062932",
            "telephone_number": "918-333-7200",
            "fax_number": "918-331-1447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 STATE ST",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "740062932",
            "telephone_number": "918-333-7200",
            "fax_number": "918-331-1447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JANE PHILLIPS MEMORIAL MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-19",
        "last_updated": "2008-05-21",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "MIKE",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "918-331-1644"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "OK",
            "license": "2190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100699490 I",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jane Phillips Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bartlesville, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.