Oklahoma Sports & Spine Medicine,PLLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

26519 Issued in OK

Legal business name

OKLAHOMA SPORTS & SPINE MEDICINE,PLLC

Practice address

121 NE 50TH St
Oklahoma City, OK 73105-1809

Phone

(405) 513-3354

NPI assigned

Oct 31, 2015

Organization subpart

No

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

Authorized official

Name

Andrea Fraley, M.D.

Title

Physician/Owner

Phone

(405) 513-3354

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1446249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446249600000",
    "number": "1851764708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 54589",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731541589",
            "telephone_number": "405-513-3354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 NE 50TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731051809",
            "telephone_number": "405-513-3354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OKLAHOMA SPORTS & SPINE MEDICINE,PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-31",
        "last_updated": "2015-10-31",
        "status": "A",
        "authorized_official_last_name": "FRALEY",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "405-513-3354",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "OK",
            "license": "26519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oklahoma Spine Hospital LLC
• Oklahoma Spine Hospital LLC
• Oklahoma Spine Surgery & Orthopedics
• Oklahoma Spine Surgery Center
• Oklahoma Spine Surgery Center Physicians Group
• Oklahoma Sports and Orthopedics Institute PLLC
• Oklahoma Sports and Orthopedics Institute PLLC
• Oklahoma Sports and Orthopedics Institute PLLC
• Oklahoma State Department of Education
• Oklahoma State Department of Health

• All providers in Oklahoma City, OK
• Physical Medicine & Rehabilitation Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2015; 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.