NPIMap

Organization Active NPI

Internal Medicine Associates of Ponca City PLLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Ponca City, OK
National Provider Identifier
1811073158
Registry record updated Jan 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
3741 Issued in OK
Legal business name
INTERNAL MEDICINE ASSOCIATES OF PONCA CITY PLLC
Practice address
100 Elmwood Ave
Ponca City, OK 74601-3406
Phone
(580) 716-1778
Fax
(580) 382-4157
NPI assigned
Oct 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2016

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

Authorized official

Name
Dr. Melinda R Allen, DO
Title
Owner DO
Phone
58076161778

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0300X 3741 OK Primary

Addresses

Primary practice location

100 Elmwood Ave
Ponca City, OK 74601-3406

Mailing address

100 Elmwood Ave
Ponca City, OK 74601-3406
Phone (580) 716-1778

Other identifiers 1

IdentifierTypeStateIssuer
200037370AMedicaidOK

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1162166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453852800000",
    "number": "1811073158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 ELMWOOD AVE",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746013406",
            "telephone_number": "580-716-1778",
            "fax_number": "580-382-4157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ELMWOOD AVE",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746013406",
            "telephone_number": "580-716-1778",
            "fax_number": "580-382-4157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE ASSOCIATES OF PONCA CITY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-30",
        "last_updated": "2016-01-27",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MELINDA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER DO",
        "authorized_official_telephone_number": "58076161778",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "OK",
            "license": "3741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200037370A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponca City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2016; 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.