NPIMap

Organization Active NPI

Saints Medical Group, LLC

Doing business as SSM Health Medical Group MWC Primary Care

  • Family Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1760077499
Registry record updated Mar 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SAINTS MEDICAL GROUP, LLC
Doing business as
SSM Health Medical Group MWC Primary Care
Practice address
1800 S Douglas Blvd
Oklahoma City, OK 73130-6224
Phone
(405) 741-7722
Fax
(405) 741-7757
NPI assigned
Mar 4, 2021
Last updated
Mar 4, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
SSM HEALTH CARE OF OKLAHOMA, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 4, 2021

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

Authorized official

Name
Crystal L Pena
Title
Provider Enrollment
Phone
(405) 272-7452

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X

Addresses

Primary practice location

1800 S Douglas Blvd
Oklahoma City, OK 73130-6224

Mailing address

1800 S Douglas Blvd
Oklahoma City, OK 73130-6224
Phone (405) 741-7722

Other names 1

  • SSM Health Medical Group MWC Primary Care Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D2018190SSM Medical Group1800 S Douglas Blvd, Midwest City, OK 73130Certificate of waiverDec 27, 2026
37D2183209SSM Health Medical Group - Pediatrics MWC1800 S Douglas Blvd, Midwest City, OK 73130Certificate of waiverApr 30, 2028

National Provider Directory

National Provider Directory
Tax ID family
Saints Medical Group LLC114 organizations share this tax ID, including this one
Part of
SSM Healthcare of Ok in

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1614816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614816000000",
    "number": "1760077499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 S DOUGLAS BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731306224",
            "telephone_number": "405-741-7722",
            "fax_number": "405-741-7757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 S DOUGLAS BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731306224",
            "telephone_number": "405-741-7722",
            "fax_number": "405-741-7757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINTS MEDICAL GROUP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SSM HEALTH CARE OF OKLAHOMA, INC.",
        "enumeration_date": "2021-03-04",
        "last_updated": "2021-03-04",
        "certification_date": "2021-02-11",
        "status": "A",
        "authorized_official_last_name": "PENA",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "405-272-7452"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SSM Health Medical Group MWC Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.