Individual provider Active NPI

Kyle Matthew George, DO

  • Emergency Medicine Physician
  • Fairfield, TX
National Provider Identifier
1982199519
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
T0214 Issued in TX
Practice address
125 Newman St
Fairfield, TX 75840-1419
Phone
(903) 389-2121
NPI assigned
Jun 26, 2018
Last updated
Jul 23, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 6656 OK
Family Medicine Physician 207Q00000X 6656 OK
Emergency Medicine Physician 207P00000X T0214 TX Primary

Addresses

Primary practice location

125 Newman St
Fairfield, TX 75840-1419

Mailing address

1650 Windmill CT
Allen, TX 75002-7385

Other practice location 1

901 S 5th Ave
Madill, OK 73446-3640
Phone (580) 795-3384

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TN, MI, WI, TX5 enrollments
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 5

Enrollment IDStateProvider typePAC IDDetails
I20191022003007 OK Practitioner - Family Practice 4688909690 Reassigns benefits to 2 organizations
I20230120000187 TN Practitioner - Family Practice 4688909690
I20230323002003 MI Practitioner - Family Practice 4688909690
I20230410000219 WI Practitioner - Family Practice 4688909690
I20230511000375 TX Practitioner - Family Practice 4688909690 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Liberty Univ College of Osteopathic Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elite Integral Staffing LLCGroup PAC ID 0648612341, 15 clinicians

Practice addresses (Care Compare)

1800 W University Blvd
Durant, OK 74701-3006
Phone (719) 688-1483

901 S 5TH Ave
Madill, OK 73446-3640
Phone (719) 688-1483

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6656OKMDPhysical Therapist
4524TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Nes Oklahoma, Inc. Emergency Medicine CurrentSince Oct 31, 2022 Accepting new patients
Ess of Fairfield LLC Emergency Medicine CurrentSince Aug 3, 2023 Accepting new patients
Elite Integral Staffing LLC Emergency Medicine CurrentSince Apr 1, 2024 Accepting new patients
Oklahoma Emergency Physician Partners PLLC Emergency Medicine Current Accepting new patients
Concord North Texas, PLLC Emergency Medicine CurrentSince Feb 17, 2023 Accepting new patients
Marshall County Hma, LLC Past Accepting new patients

Locations

1600 W University Blvd
Durant, OK 74701
Phone (580) 740-0205

1800 W University Blvd
Durant, OK 74701
Phone (580) 924-3080

901 S 5th Ave
Madill, OK 73446
Phone (580) 564-7338

1900 N 14th St
Ponca City, OK 74601
Phone (580) 718-2932

504 Lipscomb St
Bonham, TX 75418
Phone (903) 583-8585

125 Newman St
Fairfield, TX 75840
Phone (888) 250-2326

Interoperability endpoints

  • Direct secure messaging: fmckgeorg@yourcarecommunity.org

Organizations & group practices 6

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 2

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": "1529971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1982199519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 WINDMILL CT",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750027385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 NEWMAN ST",
            "city": "FAIRFIELD",
            "state": "TX",
            "postal_code": "758401419",
            "telephone_number": "903-389-2121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 S 5th Ave",
            "address_purpose": "LOCATION",
            "city": "Madill",
            "state": "OK",
            "postal_code": "734463640",
            "country_code": "US",
            "telephone_number": "580-795-3384",
            "fax_number": "580-795-0185",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "KYLE",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-26",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "6656",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "6656",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "T0214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, TX

Sources for this page

Verify at the official NPI Registry.