Anagen Medical Institute LLC

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

Legal business name

ANAGEN MEDICAL INSTITUTE LLC

Practice address

3815 S Boulevard
Edmond, OK 73013-5479

Phone

(405) 459-7779

NPI assigned

Nov 11, 2024

Organization subpart

No

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

Authorized official

Name

James Peck

Title

Ceo

Phone

(405) 760-9914

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1731283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731974400000",
    "number": "1922822600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3815 S BOULEVARD",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730135479",
            "telephone_number": "405-459-7779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3815 S BOULEVARD",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730135479",
            "telephone_number": "405-459-7779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANAGEN MEDICAL INSTITUTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-11",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A",
        "authorized_official_last_name": "PECK",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "405-760-9914"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.