First Med Clinic S 104TH LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

FIRST MED CLINIC S 104TH LLC

Practice address

1140 SW 104TH St
Oklahoma City, OK 73139-2992

Phone

(405) 691-3100

Fax

(405) 691-3106

NPI assigned

Jun 18, 2013

Last updated

Jun 18, 2013By the provider in NPPES

Organization subpart

Yes

Parent organization

ADVANCE PHYSICIANS GROUP, LLCAs reported in NPPES

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

Authorized official

Name

Mr. Todd Lechtenberger

Title

Ceo

Phone

(405) 471-6400

Specialties & licenses 1

Addresses

Part of

Advance Physiican Group

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Advance Physicians Group

  dba First Med Urgent Care

  • Urgent Care Clinic/Center
  • Shawnee, OK
  • NPI 1750395448
  NPPES parent name

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

{
    "created_epoch": "1371513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371513600000",
    "number": "1942649520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 N KELLY AVE",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730034865",
            "telephone_number": "405-471-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 SW 104TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731392992",
            "telephone_number": "405-691-3100",
            "fax_number": "405-691-3106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST MED CLINIC S 104TH LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVANCE PHYSICIANS GROUP, LLC",
        "enumeration_date": "2013-06-18",
        "last_updated": "2013-06-18",
        "status": "A",
        "authorized_official_last_name": "LECHTENBERGER",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "405-471-6400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ashley Firth, RBT
• Keith Kurt Fischborn, MD
• Laura E Fischer, M.D., M.S.

• Family Medicine Physician in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2013; 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.