Sarah Mack, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0419R Issued in OK

Practice address

1600 W University Blvd
Durant, OK 74701-3094

Phone

(580) 924-5500

Fax

(580) 924-1991

NPI assigned

Jun 29, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

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

Specialty

Family Practice

Education

Rocky Vista University College of Osteopathic Med, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Altitude Family and Internal Medicine, LLCGroup PAC ID 7911090865, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Altitude Family & Internal Medicine, LLC

  • Primary Care Clinic/Center
  • Littleton, CO
  • NPI 1720269020

  Single Specialty

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1760052062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 W UNIVERSITY BLVD",
            "city": "DURANT",
            "state": "OK",
            "postal_code": "747013094",
            "telephone_number": "580-924-5500",
            "fax_number": "580-924-1991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W UNIVERSITY BLVD",
            "city": "DURANT",
            "state": "OK",
            "postal_code": "747013094",
            "telephone_number": "580-924-5500",
            "fax_number": "580-924-1991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "SARAH",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-29",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "0419R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edith Amy Lowry, LPC CANDIDATE
• Loyalty Health Urgent Care LLC
• Ryan Richard Ludlow, DO
• Jessica Lujan
• Charlene Alexandra Lyons, MS CCC-SLP
• Michael Trent Macon, PHARMD
• Makenzie Ray Magby
• Magnolia Med Spa and IV Therapy Inc.
• Magnolia Smiles
• Marquin Lynn Malone

• Family Medicine Physician in Durant, OK
• Providers in Durant, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.