NPIMap

Organization Active NPI

State of Oklahoma

  • Psychiatry Physician
  • Norman, OK
National Provider Identifier
1972907178
Registry record updated Oct 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
STATE OF OKLAHOMA
Practice address
900 E Main St
Norman, OK 73071-5305
Phone
(405) 573-6600
Fax
(405) 573-3960
NPI assigned
Oct 17, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2014

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

Authorized official

Name
Mr. Larry Gross, LCSW
Title
Executive Director
Phone
(405) 573-6600

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X
Psychiatric Hospital 283Q00000X

Addresses

Primary practice location

900 E Main St
Norman, OK 73071-5305

Mailing address

900 E Main St
Norman, OK 73071-5305
Phone (405) 573-6600

Other identifiers 1

IdentifierTypeStateIssuer
100709440AMedicaidOK

Other names 1

  • GRIFFIN MEMORIAL HOSPITAL Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Sallisaw State Veterans Home140 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 13

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1413504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413504000000",
    "number": "1972907178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 E MAIN ST",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730715305",
            "telephone_number": "405-573-6600",
            "fax_number": "405-573-3960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 E MAIN ST",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730715305",
            "telephone_number": "405-573-6600",
            "fax_number": "405-573-3960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF OKLAHOMA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-17",
        "last_updated": "2014-10-17",
        "status": "A",
        "authorized_official_last_name": "GROSS",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "405-573-6600",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100709440A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GRIFFIN MEMORIAL HOSPITAL",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Norman, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2014; 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.