Individual provider Active NPI

Dennis R Staggs, D.O.

  • Emergency Medicine Physician
  • McAlester, OK
National Provider Identifier
1831139526
Registry record updated Dec 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2212 Issued in OK
Practice address
1 E Clark Bass Blvd
McAlester, OK 74501-4209
Phone
(918) 426-1800
Fax
(918) 421-8066
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2010

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 2212 OK Primary

Addresses

Primary practice location

1 E Clark Bass Blvd
McAlester, OK 74501-4209

Mailing address

1 E Clark Bass Blvd
McAlester, OK 74501-4209
Phone (918) 426-1800

Other identifiers 1

IdentifierTypeStateIssuer
100214950BMedicaidOK

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
I20110111000890 OK Practitioner - Emergency Medicine 6204025992 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2212OKMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians of Mid-America, P.C. Emergency Medicine CurrentSince Nov 1, 2014 Accepting new patients
Ghazi M. Rayan, MD, Inc. Past Accepting new patients
Lawton Urology Past Accepting new patients

Locations

1 E Clark Bass Blvd
McAlester, OK 74501
Phone (918) 421-6941

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

Organizations & group practices 3

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291248000000",
    "number": "1831139526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 E CLARK BASS BLVD",
            "city": "MCALESTER",
            "state": "OK",
            "postal_code": "745014209",
            "telephone_number": "918-426-1800",
            "fax_number": "918-421-8066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 E CLARK BASS BLVD",
            "city": "MCALESTER",
            "state": "OK",
            "postal_code": "745014209",
            "telephone_number": "918-426-1800",
            "fax_number": "918-421-8066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAGGS",
        "first_name": "DENNIS",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2010-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "2212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100214950B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McAlester, OK

Sources for this page

Verify at the official NPI Registry.