NPIMap

Organization Active NPI

Saint Medical Group, LLC

Doing business as SSM Health Medical Group Urogynocology

  • Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
  • Oklahoma City, OK
National Provider Identifier
1861019663
Registry record updated Jun 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urogynecology and Reconstructive Pelvic Surgery (Urology) PhysicianTaxonomy code 2088F0040X
Legal business name
SAINT MEDICAL GROUP, LLC
Doing business as
SSM Health Medical Group Urogynocology
Practice address
535 NW 9TH St Ste 210
Oklahoma City, OK 73102-1072
Phone
(405) 772-4480
Fax
(405) 772-4484
NPI assigned
Jun 29, 2020
Last updated
Jun 29, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
SSM HEALTH CARE OF OKLAHOMA, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 29, 2020

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

Authorized official

Name
Crystal L Pena
Title
Provider Enrollment Coordinator
Phone
(405) 272-7452

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VG0400X
Urogynecology and Reconstructive Pelvic Surgery (Urology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2088F0040X Primary

Addresses

Primary practice location

535 NW 9TH St Ste 210
Oklahoma City, OK 73102-1072

Mailing address

535 NW 9TH St Ste 210
Oklahoma City, OK 73102-1072
Phone (405) 772-4480

Other names 1

  • SSM Health Medical Group Urogynocology Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Saints Medical Group114 organizations share this tax ID, including this one
Part of
SSM Healthcare of Ok in

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

535 NW 9th St
Ste 210
Oklahoma City, OK 73102
Phone (405) 272-8498

NPI Registry JSON

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

{
    "created_epoch": "1593388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593388800000",
    "number": "1861019663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 NW 9TH ST STE 210",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731021072",
            "telephone_number": "405-772-4480",
            "fax_number": "405-772-4484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 NW 9TH ST STE 210",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731021072",
            "telephone_number": "405-772-4480",
            "fax_number": "405-772-4484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT MEDICAL GROUP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SSM HEALTH CARE OF OKLAHOMA, INC.",
        "enumeration_date": "2020-06-29",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A",
        "authorized_official_last_name": "PENA",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT COORDINATOR",
        "authorized_official_telephone_number": "405-272-7452"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2088F0040X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SSM Health Medical Group Urogynocology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 29, 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.