NPIMap

Organization Active NPI

Ultimate Direct Primary Care PLLC

  • Primary Care Clinic/Center
  • Ardmore, OK
National Provider Identifier
1891518304
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
ULTIMATE DIRECT PRIMARY CARE PLLC
Practice address
1111 Walnut Dr
Ardmore, OK 73401-2354
Phone
(580) 223-9008
NPI assigned
Nov 4, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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

Authorized official

Name
Dr. Lauren Southward, MDNPI 1780667378
Title
Owner
Phone
(580) 465-2283

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

1111 Walnut Dr
Ardmore, OK 73401-2354

Mailing address

1111 Walnut Dr
Ardmore, OK 73401-2354
Phone (580) 223-9008

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1730678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730678400000",
    "number": "1891518304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 WALNUT DR",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734012354",
            "telephone_number": "580-223-9008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 WALNUT DR",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734012354",
            "telephone_number": "580-223-9008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ULTIMATE DIRECT PRIMARY CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-04",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A",
        "authorized_official_last_name": "SOUTHWARD",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "580-465-2283",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ardmore, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; 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.