Ponca City Orthopaedic and Sports Medicine Clinic, Inc

Primary specialty

SpecialistTaxonomy code 174400000X

License

11690 Issued in OK

Legal business name

PONCA CITY ORTHOPAEDIC AND SPORTS MEDICINE CLINIC, INC

Practice address

119 Patton Dr
Ponca City, OK 74601-2030

Phone

(580) 765-8240

NPI assigned

Apr 20, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Lori L Boring, RT

Title

Office Manager

Phone

(580) 765-8240

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1730307422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 PATTON DR",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746012030",
            "telephone_number": "580-765-8240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 PATTON DR",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746012030",
            "telephone_number": "580-765-8240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PONCA CITY ORTHOPAEDIC AND SPORTS MEDICINE CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BORING",
        "authorized_official_first_name": "LORI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "580-765-8240",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RT"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "OK",
            "license": "11690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ponca City Immediate Care, LLC
• Ponca City Open MRI, LLC
• Ponca City Primary Care LLC
• Ponca City Public School
• Ponca Sleep Interpretors LLC
• Donald D Potter, DC
• Elexas Nicole Potter

• Specialist in Ponca City, OK
• Providers in Ponca City, OK by specialty
• Specialist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.