NPIMap

Organization Active NPI

SSM Health Care of Oklahoma, Inc

  • Internal Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1891245882
Registry record updated Oct 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SSM HEALTH CARE OF OKLAHOMA, INC
Practice address
3400 S Douglas Blvd
Suite 301
Oklahoma City, OK 73150-1001
Phone
(405) 231-8888
Fax
(405) 231-8885
NPI assigned
Oct 13, 2016
Organization subpart
Yes
Parent organization
SSM HEALTH CARE OF OKLAHOMA, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 13, 2016

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

Authorized official

Name
Crystal L Pena
Title
Insurance Credentialing Specialist
Phone
(405) 272-7452

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

3400 S Douglas Blvd
Suite 301
Oklahoma City, OK 73150-1001

Mailing address

3400 S Douglas Blvd
Suite 301
Oklahoma City, OK 73150-1001
Phone (405) 231-8888

Other names 1

  • St Anthony East-Heritage Family Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Marilyn Doughtery MD56 organizations share this tax ID, including this one
Part of
Marilyn Doughtery MD

Organizations with this tax ID in the same state 16

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

View all 16

Locations

3400 S Douglas Blvd
Ste 301
Oklahoma City, OK 73150
Phone (405) 231-8888

NPI Registry JSON

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

{
    "created_epoch": "1476316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476316800000",
    "number": "1891245882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 S DOUGLAS BLVD",
            "address_2": "SUITE 301",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731501001",
            "telephone_number": "405-231-8888",
            "fax_number": "405-231-8885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 S DOUGLAS BLVD",
            "address_2": "SUITE 301",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731501001",
            "telephone_number": "405-231-8888",
            "fax_number": "405-231-8885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SSM HEALTH CARE OF OKLAHOMA, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SSM HEALTH CARE OF OKLAHOMA, INC",
        "enumeration_date": "2016-10-13",
        "last_updated": "2016-10-13",
        "status": "A",
        "authorized_official_last_name": "PENA",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "INSURANCE CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "405-272-7452"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Anthony East-Heritage Family Medicine",
            "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 Oct 13, 2016; 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.