Organization Active NPI

LTAC Associates of Oklahoma LLC

  • Family Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1790129559
Registry record updated Apr 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LTAC ASSOCIATES OF OKLAHOMA LLC
Practice address
3801 N Classen Blvd
Suite 100
Oklahoma City, OK 73118-2871
Phone
(405) 557-1200
Fax
(405) 557-1977
NPI assigned
Apr 24, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2013

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

Authorized official

Name
Jason Martin
Title
Chief Operating Officer
Phone
(405) 557-1200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

3801 N Classen Blvd
Suite 100
Oklahoma City, OK 73118-2871

Mailing address

3801 N Classen Blvd
Suite 100
Oklahoma City, OK 73118-2871
Phone (405) 557-1200

National Provider Directory

National Provider Directory

Locations

3801 N Classen Blvd
Ste 100
Oklahoma City, OK 73118
Phone (405) 557-1200

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1366761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366761600000",
    "number": "1790129559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 N CLASSEN BLVD",
            "address_2": "SUITE 100",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731182871",
            "telephone_number": "405-557-1200",
            "fax_number": "405-557-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 N CLASSEN BLVD",
            "address_2": "SUITE 100",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731182871",
            "telephone_number": "405-557-1200",
            "fax_number": "405-557-1977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LTAC ASSOCIATES OF OKLAHOMA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-24",
        "last_updated": "2013-04-24",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "405-557-1200"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "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 Apr 24, 2013; 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.