Individual provider Active NPI

Burke Hendricks, DO

  • Emergency Medicine Physician
  • Lawton, OK
National Provider Identifier
1972031367
Registry record updated Dec 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
6415 Issued in OK
Practice address
3401 W Gore Blvd
Lawton, OK 73505-6332
Phone
(208) 206-9486
NPI assigned
May 30, 2017
Last updated
Dec 22, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 6415 OK Primary

Addresses

Primary practice location

3401 W Gore Blvd
Lawton, OK 73505-6332

Mailing address

3401 W Gore Blvd
Lawton, OK 73505-6332

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190502002558 OK Practitioner - Emergency Medicine 0547513715 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Kansas City College of Medicine and Surgery, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centurion Emergency Partners, LLCGroup PAC ID 1153853130, 13 clinicians

Practice addresses (Care Compare)

2621 N Whisenant Dr
Duncan, OK 73533-0911
Phone (580) 252-5300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.74 of 100Reported as individual
Quality
91.31
Improvement activities
0
Cost
79.05

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6415OKMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians of Mid-America, P.C. Emergency Medicine CurrentSince Nov 1, 2022 Accepting new patients
Elite Hospital Partners of Oklahoma Emergency Medicine CurrentSince Jan 2, 2024 Accepting new patients
South Central Emergency Services PC Emergency Medicine CurrentSince May 1, 2020 Accepting new patients
Centurion Emergency Partners LLC Emergency Medicine CurrentSince Nov 5, 2024 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Duncan Regional Hospital, Inc. Past Accepting new patients

Locations

1407 N Whisenant Dr
Duncan, OK 73533
Phone (580) 251-8458

1415 N Whisenant Dr
Duncan, OK 73533
Phone (580) 251-6657

3401 W Gore Blvd
Lawton, OK 73505
Phone (580) 483-5207

1000 N Lee Ave
Oklahoma City, OK 73102
Phone (405) 272-6152

3400 S Douglas Blvd
Oklahoma City, OK 73150
Phone (405) 272-2850

1102 W MacArthur St
Shawnee, OK 74804
Phone (405) 273-2270

1323 W 6th Ave
Stillwater, OK 74074
Phone (405) 372-1480

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1496102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608595200000",
    "number": "1972031367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 W GORE BLVD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 W GORE BLVD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056332",
            "telephone_number": "208-206-9486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKS",
        "first_name": "BURKE",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-30",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "6415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawton, OK

Sources for this page

Verify at the official NPI Registry.