Organization Active NPI

Medi Practice Management LLC

  • Internal Medicine Physician
  • Edmond, OK
National Provider Identifier
1962024893
Registry record updated May 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MEDI PRACTICE MANAGEMENT LLC
Practice address
3008 NW 168TH CT
Edmond, OK 73012-6787
Phone
(580) 210-0040
NPI assigned
May 14, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2020

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

Authorized official

Name
Ms. Samina Anwar
Title
Owner
Phone
(580) 210-0040

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

3008 NW 168TH CT
Edmond, OK 73012-6787

Mailing address

3008 NW 168TH CT
Edmond, OK 73012-6787
Phone (580) 210-0040

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200603001137 OK Part B Supplier - Clinic/Group Practice 7012338809 Receives reassigned benefits from 2 practitioners
Practice locations: Edmond, OK

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1589414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589414400000",
    "number": "1962024893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3008 NW 168TH CT",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730126787",
            "telephone_number": "580-210-0040",
            "fax_number": "405-330-9082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3008 NW 168TH CT",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730126787",
            "telephone_number": "580-210-0040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDI PRACTICE MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-14",
        "last_updated": "2020-05-14",
        "certification_date": "2020-05-14",
        "status": "A",
        "authorized_official_last_name": "ANWAR",
        "authorized_official_first_name": "SAMINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "580-210-0040",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.