NPIMap

Individual provider Active NPI

Michael W Carnahan, MD

  • Family Medicine Physician
  • Ardmore, OK
National Provider Identifier
1871607903
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
16887 Issued in OK
Practice address
1104 Walnut Dr
Ardmore, OK 73401-2353
Phone
(580) 226-0543
Fax
(580) 226-2284
NPI assigned
Aug 18, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 16887 OK Primary

Addresses

Primary practice location

1104 Walnut Dr
Ardmore, OK 73401-2353

Mailing address

1104 Walnut Dr
Ardmore, OK 73401-2353
Phone (580) 226-0543

Other identifiers 1

IdentifierTypeStateIssuer
100131180AMedicaidOK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100316000116 OK Practitioner - Family Practice 6608769377 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Oklahoma College of Medicine, 1986
Medicare assignment
May accept Medicare assignment
Group practices
Good Shepherd Community Clinic, Inc.Group PAC ID 4284936337, 19 clinicians
Family Practice AssociatesGroup PAC ID 6204729957, 2 clinicians

Practice addresses (Care Compare)

1104 Walnut Dr
Ardmore, OK 73401-2353

1306 12TH Ave NW
Ardmore, OK 73401-1285

20 12TH Ave NW
Ardmore, OK 73401-5722

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.91 of 100Reported as individual
Quality
86.95
Promoting interoperability
95
Improvement activities
40
Cost
66.92

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Good Shepherd Community Clinic, Inc. CurrentSince Aug 15, 2020 Accepting new patients
Family Practice Associates Family Medicine CurrentSince Jul 1, 1989 Accepting new patients
Summit Medical Center Past Accepting new patients
Mercy Hospital Ardmore, Inc. Past Accepting new patients

Locations

1104 Walnut Dr
Ardmore, OK 73401
Phone 5802233411308

1116 Walnut Dr
Ardmore, OK 73401
Phone (580) 226-0543

1306 12th Ave NW
Ardmore, OK 73401
Phone (580) 223-6003

20 12th Ave NW
Ardmore, OK 73401
Phone (580) 223-3411

2401 N Commerce St
Ste A
Ardmore, OK 73401
Phone (580) 798-4122

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21885/brand/1/csg/1/fhir/r4
  • Direct secure messaging: michael.carnahan.1@21725.direct.athenahealth.com
  • Direct secure messaging: michael.carnahan.1@21885.direct.athenahealth.com

Organizations & group practices 4

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

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1871607903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 WALNUT DR",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734012353",
            "telephone_number": "580-226-0543",
            "fax_number": "580-226-2284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 WALNUT DR",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734012353",
            "telephone_number": "580-226-0543",
            "fax_number": "580-226-2284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARNAHAN",
        "first_name": "MICHAEL",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "16887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100131180A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ardmore, OK

Sources for this page

Verify at the official NPI Registry.