Advanced Family Therapeutic

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

ADVANCED FAMILY THERAPEUTIC

Practice address

3280 Marshall Ave
Norman, OK 73072

Phone

(405) 579-5858

Fax

(405) 292-1787

NPI assigned

Oct 10, 2005

Organization subpart

No

Name

Mr. Gregory E Shadid, MD

Title

Co Owner

Phone

(405) 579-5858

• Bishopcreek Medical and Counseling Group Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 8, 2008.

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220832000000",
    "number": "1942298385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3280 MARSHALL AVE",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730728028",
            "telephone_number": "405-579-5858",
            "fax_number": "405-292-1787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3280 MARSHALL AVE",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "73072",
            "telephone_number": "405-579-5858",
            "fax_number": "405-292-1787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED FAMILY THERAPEUTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-10",
        "last_updated": "2008-09-08",
        "status": "A",
        "authorized_official_last_name": "SHADID",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CO OWNER",
        "authorized_official_telephone_number": "405-579-5858",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200019720A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bishopcreek Medical and Counseling Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Norman, OK
• Medical Specialty Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2008; 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.