Individual provider Active NPI

Tyler Clayton Stephens, D.O.

  • Emergency Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1811304199
Registry record updated Jul 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0055R Issued in OK
Practice address
10304 Southridge Ter
Oklahoma City, OK 73159-7326
Phone
(405) 623-8095
NPI assigned
Jul 17, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 0055R OK Primary

Addresses

Primary practice location

10304 Southridge Ter
Oklahoma City, OK 73159-7326

Mailing address

10304 Southridge Ter
Oklahoma City, OK 73159-7326
Phone (405) 623-8095

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150923002741 OK Practitioner - Emergency Medicine 0446567408 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5818OKMDCounselor
0055ROKMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians of Mid-America, P.C. Emergency Medicine CurrentSince Aug 14, 2017 Accepting new patients
Emergency Services of Oklahoma PC Emergency Medicine CurrentSince Oct 1, 2016 Accepting new patients
Oklahoma Emergency Physician Partners PLLC Emergency Medicine Current Accepting new patients
South Central Emergency Services PC Emergency Medicine CurrentSince Sep 30, 2016 Accepting new patients
Integris South Oklahoma City Hospital Corporation Past Accepting new patients

Locations

1800 W University Blvd
Durant, OK 74701
Phone (580) 924-3080

200 2nd Ave SW
Miami, OK 74354
Phone (918) 540-7113

4050 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 608-3200

4401 S Western Ave
Oklahoma City, OK 73109
Phone (405) 636-7000

1102 W MacArthur St
Shawnee, OK 74804
Phone (405) 273-2270

1323 W 6th Ave
Stillwater, OK 74074
Phone (405) 372-1480

1201 Health Center Pkwy
Yukon, OK 73099
Phone (405) 717-6800

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1405555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405555200000",
    "number": "1811304199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10304 SOUTHRIDGE TER",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731597326",
            "telephone_number": "405-623-8095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10304 SOUTHRIDGE TER",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731597326",
            "telephone_number": "405-623-8095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "TYLER",
        "middle_name": "CLAYTON",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-17",
        "last_updated": "2014-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "0055R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.