NPIMap

Organization Active NPI

Southern Oklahoma Surgical Center Inc

  • Ambulatory Surgical Clinic/Center
  • Ardmore, OK
National Provider Identifier
1942292073
Registry record updated Nov 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
0023 Issued in OK
Legal business name
SOUTHERN OKLAHOMA SURGICAL CENTER INC
Practice address
2412 North Commerce
Ardmore, OK 73401-1356
Phone
(580) 226-5000
Fax
(580) 226-5035
NPI assigned
Aug 16, 2005
Last updated
Nov 18, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2008

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

Authorized official

Name
Christy Morris, RN
Title
Administrator
Phone
(580) 226-5000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 0023 OK Primary

Addresses

Primary practice location

2412 North Commerce
Ardmore, OK 73401-1356

Mailing address

2412 North Commerce
Ardmore, OK 73401-1356
Phone (580) 226-5000

Other identifiers 3

IdentifierTypeStateIssuer
490000424OtherOKRAILROAD MEDICARE
100736890AMedicaidOK
000371010001OtherOKBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091202000654 OK Part B Supplier - Ambulatory Surgical Center 4082514708 Practice locations: Ardmore, OK

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Southern Oklahoma Surgical Center IncCCN 37C0001010
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Southern Oklahoma Surgical2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226966400000",
    "number": "1942292073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2412 NORTH COMMERCE",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734011356",
            "telephone_number": "580-226-5000",
            "fax_number": "580-226-5035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2412 NORTH COMMERCE",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734011356",
            "telephone_number": "580-226-5000",
            "fax_number": "580-226-5035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN OKLAHOMA SURGICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-16",
        "last_updated": "2008-11-18",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "CHRISTY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "580-226-5000",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "OK",
            "license": "0023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "490000424",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100736890A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000371010001",
            "state": "OK"
        }
    ],
    "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 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.