NPIMap

Individual provider Active NPI

Jane Detrich, DO

  • Hospitalist Physician
  • Oklahoma City, OK
National Provider Identifier
1992149389
Registry record updated Jul 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
5551 Issued in OK
Practice address
4300 W Memorial Rd
Oklahoma City, OK 73120-8304
Phone
(405) 752-3962
Fax
(405) 752-3963
NPI assigned
Apr 29, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 5551 OK Primary

Addresses

Primary practice location

4300 W Memorial Rd
Oklahoma City, OK 73120-8304

Mailing address

4300 W Memorial Rd
Oklahoma City, OK 73120-8304
Phone (405) 752-3962

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160706001860 OK Practitioner - Internal Medicine 2062704331 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Oklahoma College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Oklahoma CommunitiesGroup PAC ID 1153468921, 645 clinicians

Practice addresses (Care Compare)

4300 McAuley Blvd
Oklahoma City, OK 73120-8302
Phone (405) 936-5455

4300 W Memorial Rd
Oklahoma City, OK 73120-8304
Phone (405) 755-1515

Hospital & facility affiliations

  • Mercy Hospice Hospice, Oklahoma City, OK, CCN 371509
  • Mercy Hospital Oklahoma City, Inc Hospital, Oklahoma City, OK, CCN 370013
  • Mercy Hospital Ada Hospital, Ada, OK, CCN 370020
  • Oklahoma Heart Hospital, LLC Hospital, Oklahoma City, OK, CCN 370215
  • Oklahoma Heart Hospital South, LLC Hospital, Oklahoma City, OK, CCN 370234

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Tishomingo, Inc CurrentSince Mar 1, 2019 Accepting new patients
Mercy Hospital Tishomingo, Inc. CurrentSince Mar 1, 2019 Accepting new patients
Mercy Hospital Logan County Inc CurrentSince Mar 1, 2019 Accepting new patients
Mercy Hospital Logan County, Inc CurrentSince Mar 1, 2019 Accepting new patients
Mercy Clinic Oklahoma Communities CurrentSince Aug 1, 2016 Accepting new patients
Mercy Hospital Kingfisher, Inc CurrentSince Mar 1, 2019 Accepting new patients
Mercy Hospital Watonga Inc CurrentSince Mar 1, 2019 Accepting new patients
Mercy Hospital Oklahoma City, Inc Past Accepting new patients

Locations

200 S Academy Rd
Guthrie, OK 73044
Phone (405) 260-4165

1000 Hospital Dr
Kingfisher, OK 73750
Phone (405) 375-3141

4300 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 752-3962

4300 McAuley Blvd
Oklahoma City, OK 73120
Phone (405) 936-5455

1000 S Byrd St
Tishomingo, OK 73460
Phone (580) 371-2327

500 N Clarence Nash Blvd
Watonga, OK 73772
Phone (580) 623-2233

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1367193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469750400000",
    "number": "1992149389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 W MEMORIAL RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731208304",
            "telephone_number": "405-752-3962",
            "fax_number": "405-752-3963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 W MEMORIAL RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731208304",
            "telephone_number": "405-752-3962",
            "fax_number": "405-752-3963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETRICH",
        "first_name": "JANE",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-29",
        "last_updated": "2016-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OK",
            "license": "5551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.