Individual provider Active NPI

James Paul Ice, MD

  • Preventive Medicine/Occupational Environmental Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1972599454
Registry record updated May 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preventive Medicine/Occupational Environmental Medicine PhysicianTaxonomy code 2083P0500X
License
17299 Issued in OK
Practice address
36 W Memorial Rd Ste C3
Oklahoma City, OK 73114-2312
Phone
(405) 755-3110
Fax
(405) 755-3159
NPI assigned
Sep 21, 2005
Last updated
May 12, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Aerospace Medicine Physician 2083A0100X 17299 OK
Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X 17299 OK Primary

Addresses

Primary practice location

36 W Memorial Rd Ste C3
Oklahoma City, OK 73114-2312

Mailing address

36 W Memorial Rd Ste C3
Oklahoma City, OK 73114-2312
Phone (405) 755-3110

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
I20111103000353 OK Practitioner - Preventive Medicine 9436322609 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17299OKMDPreventive Medicine/Occupational Environmental Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care P.a. CurrentSince Aug 31, 2011 Accepting new patients
American Current Care, PA CurrentSince Aug 31, 2011 Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

36 W Memorial Rd
Ste C3
Oklahoma City, OK 73114
Phone (405) 755-3110

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431388800000",
    "number": "1972599454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 W MEMORIAL RD STE C3",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731142312",
            "telephone_number": "405-755-3110",
            "fax_number": "405-755-3159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 W MEMORIAL RD STE C3",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731142312",
            "telephone_number": "405-755-3110",
            "fax_number": "405-755-3159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ICE",
        "first_name": "JAMES",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-21",
        "last_updated": "2015-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083A0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Aerospace Medicine",
            "state": "OK",
            "license": "17299",
            "primary": false
        },
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "OK",
            "license": "17299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.