Active NPI
Good to Go LLC Dba Vista Medical Center
- Family Medicine Physician
- Oklahoma City, OK
National Provider Identifier
1811061625
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 261QM2500X
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 261QM2500X | Other | OK | TAXONOMY |
National Provider Directory
National Provider DirectoryNPI 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.