NPIMap

Organization Active NPI

Saints Medical Group

Doing business as Saints Dermatology Midwest City

  • Dermatology Physician
  • Midwest City, OK
National Provider Identifier
1780970186
Registry record updated Jul 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
SAINTS MEDICAL GROUP
Doing business as
Saints Dermatology Midwest City
Practice address
9020 E Reno Ave
Suite 100
Midwest City, OK 73130-3336
Phone
(405) 732-0397
Fax
(405) 737-5901
NPI assigned
Jun 23, 2011
Last updated
Jul 29, 2011By 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 Jul 29, 2011

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X Primary
Family Medicine Physician 207Q00000X

Addresses

Primary practice location

9020 E Reno Ave
Suite 100
Midwest City, OK 73130-3336

Mailing address

9020 E Reno Ave
Suite 100
Midwest City, OK 73130-3336
Phone (405) 732-0397

Other names 1

  • Saints Dermatology Midwest City Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Saint Medical Group LLC114 organizations share this tax ID, including this one
Part of
Sah Op CLN

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

Locations

9020 E Reno Ave
Ste 100
Midwest City, OK 73130
Phone (405) 732-0397

NPI Registry JSON

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

{
    "created_epoch": "1308787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311897600000",
    "number": "1780970186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9020 E RENO AVE",
            "address_2": "SUITE 100",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731303336",
            "telephone_number": "405-732-0397",
            "fax_number": "405-737-5901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9020 E RENO AVE",
            "address_2": "SUITE 100",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731303336",
            "telephone_number": "405-732-0397",
            "fax_number": "405-737-5901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINTS MEDICAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SSM HEALTHCARE OF OK, INC",
        "enumeration_date": "2011-06-23",
        "last_updated": "2011-07-29",
        "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": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Saints Dermatology Midwest City",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Midwest City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2011; 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.