NPIMap

Organization Active NPI

Board of Regents of the Univ of Oklahoma-Ou Phys Residents Clinic (Int

  • Clinic/Center
  • Oklahoma City, OK
National Provider Identifier
1851486849
Registry record updated Jan 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
BOARD OF REGENTS OF THE UNIV OF OKLAHOMA-OU PHYS RESIDENTS CLINIC (INT
Practice address
711 Stanton L Young Blvd Ste 524
Oklahoma City, OK 73104
Phone
(405) 271-3900
NPI assigned
Oct 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2020

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

Authorized official

Name
John P Zubialde, MDNPI 1477521128
Title
Executive Dean
Phone
(405) 271-1515

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

711 Stanton L Young Blvd Ste 524
Oklahoma City, OK 73104

Mailing address

1122 NE 13TH St # 274
Oklahoma City, OK 73117-1039
Phone (405) 271-1515

Other identifiers 2

IdentifierTypeStateIssuer
200284240AMedicaidOK
100744720GMedicaidOK

Other names 1

  • OU Physicians Residents Clinic (Internal Medicine) Other name

National Provider Directory

National Provider Directory
Tax ID family
Board of Regents of the Univ of Oklahoma-Ou Phys Edmond Clinic38 organizations share this tax ID, including this one

Other organizations with this tax ID 37

Organizations that report the same tax identification number in the National Provider Directory.

View all 37

Locations

711 Stanton L Young Blvd
Ste 524
Oklahoma City, OK 73104
Phone (405) 271-3900

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578268800000",
    "number": "1851486849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 NE 13TH ST # 274",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731171039",
            "telephone_number": "405-271-1515",
            "fax_number": "405-271-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 STANTON L YOUNG BLVD STE 524",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73104",
            "telephone_number": "405-271-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOARD OF REGENTS OF THE UNIV OF OKLAHOMA-OU PHYS RESIDENTS CLINIC (INT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A",
        "authorized_official_last_name": "ZUBIALDE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "EXECUTIVE DEAN",
        "authorized_official_telephone_number": "405-271-1515",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200284240A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100744720G",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OU Physicians Residents Clinic (Internal Medicine)",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "OU Physicians Residents Clinic (Internal Medicine)",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Jan 6, 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.