Genesiscare Landmark Imaging PC

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

GENESISCARE LANDMARK IMAGING PC

Practice address

111 Harrison Ave Ste 104
Oklahoma City, OK 73104-1819

Phone

(405) 272-5090

Fax

(405) 272-5091

NPI assigned

Aug 28, 2020

Organization subpart

No

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

Authorized official

Name

Jeffrey T. Triplett, MD

Title

President

Phone

(405) 272-5090

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Genesiscare Landmark Imaging PC2 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.

• Genesiscare Landmark Imaging PC

  • Physiological Laboratory
  • Muskogee, OK
  • NPI 1932793007
  NPD tax ID

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

{
    "created_epoch": "1598572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614556800000",
    "number": "1962015818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 COLONIAL BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071410",
            "telephone_number": "239-931-7342",
            "fax_number": "239-931-7385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 HARRISON AVE STE 104",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731041819",
            "telephone_number": "405-272-5090",
            "fax_number": "405-272-5091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESISCARE LANDMARK IMAGING PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-28",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A",
        "authorized_official_last_name": "TRIPLETT",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "405-272-5090",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physiological Laboratory in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Physiological Laboratory in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.