South Moore Medical Clinic,PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SOUTH MOORE MEDICAL CLINIC,PC

Doing business as

South Moore Medical Clinic

Practice address

14800 S Western Ave
Moore, OK 73170-7112

Phone

(405) 912-4900

Fax

(405) 912-4903

NPI assigned

Jun 12, 2006

Organization subpart

No

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

Authorized official

Name

Keith R. Layne, M.D.

Title

Physician

Phone

(405) 912-4900

Specialties & licenses 1

Addresses

Other names 1

• South Moore Medical Clinic Doing business as

Practitioners 1

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

• Jennifer A McReynolds, P.A.

  • Physician Assistant
  • Oklahoma City, OK
  • NPI 1942224100
  NPD (past)

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972545218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25887",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731250887",
            "telephone_number": "405-912-4900",
            "fax_number": "405-912-4903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14800 S WESTERN AVE",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731707112",
            "telephone_number": "405-912-4900",
            "fax_number": "405-912-4903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH MOORE MEDICAL CLINIC,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LAYNE",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "405-912-4900",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Moore Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tori Smith
• Abigail Yi Snow
• Margaret Snyder
• Armando Jordan Soto
• South Moore Medical Clinic, PC
• South Sooner Dental Partners
• Sparks Medical Consulting LLC
• Audrianna Sparks
• Audrey Yvonne Spear, APRN-CNP, PMHNP-BC
• Stephanie Leigh Spears, DPT

• Family Medicine Physician in Moore, OK
• Providers in Moore, 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 Aug 22, 2020; 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.