Individual provider Active NPI

Vincel Ray Cordry Jr., DO

  • Psychiatry Physician
  • Oklahoma City, OK
National Provider Identifier
1750359311
Registry record updated Apr 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
1753 Issued in OK
Practice address
4400 N Lincoln Blvd
Oklahoma City, OK 73105-5104
Phone
(405) 424-7711
Fax
(405) 419-3042
NPI assigned
Mar 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 1753 OK Primary

Addresses

Primary practice location

4400 N Lincoln Blvd
Oklahoma City, OK 73105-5104

Mailing address

4400 N Lincoln Blvd
Oklahoma City, OK 73105-5104
Phone (405) 424-7711

Other identifiers 2

IdentifierTypeStateIssuer
100134520EMedicaidOK
100134520FMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040729001135 OK Practitioner - Psychiatry 2567432180 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Kansas City Homeopathic Medical College, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Oklahoma Mental Health CouncilGroup PAC ID 3173514387, 69 clinicians

Practice addresses (Care Compare)

4400 N Lincoln Blvd
Red Rock Behavioral Health Services
Oklahoma City, OK 73105-5104
Phone (405) 424-7711

Merit-based Incentive Payment System (MIPS)

Final score
72.37 of 100Reported as group
Quality
54.6
Improvement activities
40
Cost
74.45

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1753OKMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
State of Oklahoma Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: vcordry22965@ouhealth.direct-ci.net

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554854400000",
    "number": "1750359311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 N LINCOLN BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731055104",
            "telephone_number": "405-424-7711",
            "fax_number": "405-419-3042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 N LINCOLN BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731055104",
            "telephone_number": "405-424-7711",
            "fax_number": "405-419-3042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDRY",
        "first_name": "VINCEL",
        "middle_name": "RAY",
        "name_suffix": "Jr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2019-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OK",
            "license": "1753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100134520E",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100134520F",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.