NPIMap

Organization Active NPI

Saint Medical Group, LLC

  • Family Medicine Physician
  • Choctaw, OK
National Provider Identifier
1982351979
Registry record updated Mar 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SAINT MEDICAL GROUP, LLC
Practice address
15679 NE 23Rd St
Choctaw, OK 73020-8592
Phone
(405) 390-9600
Fax
(405) 390-9400
NPI assigned
Mar 9, 2022
Organization subpart
Yes
Parent organization
SSM HEALTH CARE OF OKLAHOMA, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 9, 2022

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

Authorized official

Name
Crystal L Pena
Title
Provider Enrollment
Phone
(405) 272-7452

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

15679 NE 23Rd St
Choctaw, OK 73020-8592

Mailing address

15679 NE 23Rd St
Choctaw, OK 73020-8592
Phone (405) 390-9600

Other names 1

  • SSM Health Choctaw Family Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Saints Neurology of Enid114 organizations share this tax ID, including this one
Part of
Marilyn Doughtery MD

Organizations with this tax ID in the same state 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1646784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646784000000",
    "number": "1982351979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15679 NE 23RD ST",
            "city": "CHOCTAW",
            "state": "OK",
            "postal_code": "730208592",
            "telephone_number": "405-390-9600",
            "fax_number": "405-390-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15679 NE 23RD ST",
            "city": "CHOCTAW",
            "state": "OK",
            "postal_code": "730208592",
            "telephone_number": "405-390-9600",
            "fax_number": "405-390-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT MEDICAL GROUP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SSM HEALTH CARE OF OKLAHOMA, INC.",
        "enumeration_date": "2022-03-09",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A",
        "authorized_official_last_name": "PENA",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "405-272-7452"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SSM Health Choctaw Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Choctaw, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2022; 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.