NPIMap

Organization Active NPI

Saints Medical Group LLC

Doing business as Saints Dermatology North

  • Dermatology Physician
  • Oklahoma City, OK
National Provider Identifier
1770845729
Registry record updated Jun 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
26344 Issued in OK
Legal business name
SAINTS MEDICAL GROUP LLC
Doing business as
Saints Dermatology North
Practice address
13128 N Macarthur Blvd
Oklahoma City, OK 73142-3017
Phone
(405) 272-7044
Fax
(405) 272-7049
NPI assigned
Jun 14, 2012
Last updated
Jun 14, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
SSM HEALTHCARE OF OK, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 14, 2012

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

Authorized official

Name
Crystal L Pena
Title
Insurance Credentialing Specialist
Phone
(405) 272-7452

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 26344 OK Primary

Addresses

Primary practice location

13128 N Macarthur Blvd
Oklahoma City, OK 73142-3017

Mailing address

13128 N Macarthur Blvd
Oklahoma City, OK 73142-3017
Phone (405) 272-7044

Other names 1

  • Saints Dermatology North Doing business as

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": "1339632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339632000000",
    "number": "1770845729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13128 N MACARTHUR BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731423017",
            "telephone_number": "405-272-7044",
            "fax_number": "405-272-7049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13128 N MACARTHUR BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731423017",
            "telephone_number": "405-272-7044",
            "fax_number": "405-272-7049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINTS MEDICAL GROUP LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SSM HEALTHCARE OF OK, INC",
        "enumeration_date": "2012-06-14",
        "last_updated": "2012-06-14",
        "status": "A",
        "authorized_official_last_name": "PENA",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "INSURANCE CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "405-272-7452"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OK",
            "license": "26344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Saints Dermatology North",
            "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 Jun 14, 2012; 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.