Individual provider Active NPI

Sam L Earnest, M.D.

  • Internal Medicine Physician
  • Stillwater, OK
National Provider Identifier
1962488742
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
9696 Issued in OK
Practice address
1815 W 6TH Ave
Stillwater, OK 74074-4202
Phone
(405) 743-7300
Fax
(405) 743-7290
NPI assigned
Dec 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 9696 OK Primary

Addresses

Primary practice location

1815 W 6TH Ave
Stillwater, OK 74074-4202

Mailing address

6600 S Yale Ave
Ste 1400
Tulsa, OK 74136-3310
Phone (918) 488-6001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
9696OKMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208649600000",
    "number": "1962488742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 S YALE AVE",
            "address_2": "STE 1400",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363310",
            "telephone_number": "918-488-6001",
            "fax_number": "918-488-6010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 W 6TH AVE",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740744202",
            "telephone_number": "405-743-7300",
            "fax_number": "405-743-7290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EARNEST",
        "first_name": "SAM",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2008-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "9696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stillwater, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.