State of Oklahoma Medical Center LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

STATE OF OKLAHOMA MEDICAL CENTER LLC

Practice address

101 Park Ave Ste 1300
Oklahoma City, OK 73102-7216

Phone

(510) 456-8143

NPI assigned

Jun 23, 2025

Organization subpart

No

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

Authorized official

Name

Cristine Hernandez

Title

Ceo

Phone

(510) 456-8143

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1750636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750636800000",
    "number": "1740177401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4570 S EASTERN AVE STE 28",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891196183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 PARK AVE STE 1300",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731027216",
            "telephone_number": "510-456-8143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF OKLAHOMA MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-23",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "CRISTINE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "510-456-8143"
    },
    "taxonomies": [
        {
            "code": "2084B0040X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• State of Oklahoma Board of Regents the Univ of Okla Health Science Ctr
• State of Oklahoma Department of Human Services
• State of Oklahoma Dept of Human Services
• State of Oklahoma Dept. of Human Services
• State of Oklahoma Dept. of Human Services
• Vickie Staten-Ford
• Chealsey States
• Whitney Jean Statham, PH.D., LP
• Hannah Lynn Staton, PT, DPT
• Nicole Staton

• General Practice Physician in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• General Practice Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2025; 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.