Organization Active NPI

Good to Go LLC Dba Vista Medical Center

  • Family Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1811061625
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
261QM2500X Issued in OK
Legal business name
GOOD TO GO LLC DBA VISTA MEDICAL CENTER
Practice address
3700 S Western Ave
Oklahoma City, OK 73109-3402
Phone
(405) 634-2929
Fax
(405) 634-5055
NPI assigned
Nov 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Patrick Anson Reynolds
Title
Member
Phone
(405) 634-2929

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X 261QM2500X OK Primary

Addresses

Primary practice location

3700 S Western Ave
Oklahoma City, OK 73109-3402

Mailing address

3700 S Western Ave
Oklahoma City, OK 73109-3402
Phone (405) 634-2929

Other identifiers 1

IdentifierTypeStateIssuer
261QM2500XOtherOKTAXONOMY

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811061625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 S WESTERN AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731093402",
            "telephone_number": "405-634-2929",
            "fax_number": "405-634-5055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 S WESTERN AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731093402",
            "telephone_number": "405-634-2929",
            "fax_number": "405-634-5055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD TO GO LLC DBA VISTA MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "ANSON",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "405-634-2929",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "261QM2500X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMY",
            "identifier": "261QM2500X",
            "state": "OK"
        }
    ],
    "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 Aug 22, 2020; 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.