NPIMap

Organization Active NPI

Board of Regents of the Univ of Oklahoma-Ou Phys Edmond Clinic

  • Clinic/Center
  • Edmond, OK
National Provider Identifier
1740383603
Registry record updated Oct 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
BOARD OF REGENTS OF THE UNIV OF OKLAHOMA-OU PHYS EDMOND CLINIC
Practice address
105 N Bryant
Suite 305
Edmond, OK 73034
Phone
(405) 330-8641
NPI assigned
Sep 6, 2006
Last updated
Oct 5, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2009

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

Authorized official

Name
Brian Maddy
Title
Chief Executive Officer
Phone
(405) 271-1515

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

105 N Bryant
Suite 305
Edmond, OK 73034

Mailing address

1122 NE 13TH St
Ori236
Oklahoma City, OK 73117-1039
Phone (405) 271-1515

Other identifiers 1

IdentifierTypeStateIssuer
1173440010OtherOKDME PALMETTO MEDICARE

Other names 1

  • OU Physicians Edmond Clinic Other name

National Provider Directory

National Provider Directory
Tax ID family
Board of Regents of the Univ of Oklahoma-Ou Phys Cade Cancer Hemaonc38 organizations share this tax ID, including this one

Other organizations with this tax ID 37

Organizations that report the same tax identification number in the National Provider Directory.

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254700800000",
    "number": "1740383603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 NE 13TH ST",
            "address_2": "ORI236",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731171039",
            "telephone_number": "405-271-1515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 N BRYANT",
            "address_2": "SUITE 305",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "73034",
            "telephone_number": "405-330-8641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOARD OF REGENTS OF THE UNIV OF OKLAHOMA-OU PHYS EDMOND CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-06",
        "last_updated": "2009-10-05",
        "status": "A",
        "authorized_official_last_name": "MADDY",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "405-271-1515"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME PALMETTO MEDICARE",
            "identifier": "1173440010",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OU Physicians Edmond Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Edmond, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2009; 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.