NPIMap

Organization Active NPI

Ebenezer Healthcare Services,

  • Primary Care Clinic/Center
  • Oklahoma City, OK
National Provider Identifier
1770766610
Registry record updated May 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
EBENEZER HEALTHCARE SERVICES,
Practice address
10444 Greenbriar Place
Suite C
Oklahoma City, OK 73159-7660
Phone
(405) 378-2119
Fax
(405) 759-7022
NPI assigned
Dec 14, 2007
Last updated
May 25, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2010

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

Authorized official

Name
Mrs. Maria Agnes E Smith, ARNP,BCNPI 1386674125
Title
Ceo
Phone
(405) 378-2119

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

10444 Greenbriar Place
Suite C
Oklahoma City, OK 73159-7660

Mailing address

10444 Greenbriar Place,
Suite C
Oklahoma City, OK 73159-7660
Phone (405) 378-2119

National Provider Directory

National Provider Directory

Locations

10444 Greenbriar Pl
Ste C
Oklahoma City, OK 73159
Phone (405) 378-2119

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1197590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274745600000",
    "number": "1770766610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10444 GREENBRIAR PLACE,",
            "address_2": "SUITE C",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731597660",
            "telephone_number": "405-378-2119",
            "fax_number": "405-759-7022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10444 GREENBRIAR PLACE",
            "address_2": "SUITE C",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731597660",
            "telephone_number": "405-378-2119",
            "fax_number": "405-759-7022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EBENEZER HEALTHCARE SERVICES,",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-14",
        "last_updated": "2010-05-25",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "MARIA AGNES",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "405-378-2119",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "ARNP,BC"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 May 25, 2010; 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.