NPIMap

Organization Active NPI

SSM Health Care of Oklahoma, Inc

  • Family Medicine Physician
  • Midwest City, OK
National Provider Identifier
1801190061
Registry record updated Jul 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SSM HEALTH CARE OF OKLAHOMA, INC
Practice address
6908 E Reno Ave
Building 1
Midwest City, OK 73110-2128
Phone
(405) 737-6871
Fax
(405) 733-4281
NPI assigned
Jan 3, 2011
Organization subpart
Yes
Parent organization
SSM HEALTHCARE OF OKLAHOMA INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 8, 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 1

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

Addresses

Primary practice location

6908 E Reno Ave
Building 1
Midwest City, OK 73110-2128

Mailing address

PO Box 269064
Oklahoma City, OK 73126-9064
Phone (405) 737-6871

Other names 1

  • ST ANTHONY HERITAGE FAMILY MEDICINE Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Marilyn Doughtery MD56 organizations share this tax ID, including this one
Part of
Marilyn Doughtery MD

Organizations with this tax ID in the same state 22

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

View all 22

Locations

6908 E Reno Ave
Bldg 1
Midwest City, OK 73110
Phone (405) 737-6871

3400 S Douglas Blvd
Oklahoma City, OK 73150
Phone (405) 815-5000

NPI Registry JSON

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

{
    "created_epoch": "1294012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310083200000",
    "number": "1801190061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 269064",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731269064",
            "telephone_number": "405-737-6871",
            "fax_number": "405-733-4281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6908 E RENO AVE",
            "address_2": "BUILDING 1",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731102128",
            "telephone_number": "405-737-6871",
            "fax_number": "405-733-4281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SSM HEALTH CARE OF OKLAHOMA, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SSM HEALTHCARE OF OKLAHOMA INC",
        "enumeration_date": "2011-01-03",
        "last_updated": "2011-07-08",
        "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": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST ANTHONY HERITAGE FAMILY MEDICINE",
            "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 8, 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.