Southcrest Medical Group LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

SOUTHCREST MEDICAL GROUP LLC

Practice address

6528 E 101St St
Ste I
Tulsa, OK 74133-6724

Phone

(918) 294-4803

NPI assigned

Jul 5, 2006

Last updated

Apr 20, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Debbie Brewer

Title

Director of Provider Enrollment

Phone

(877) 892-9813

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1992736250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7100 COMMERCE WAY",
            "address_2": "SUITE 180",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370272829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6528 E 101ST ST",
            "address_2": "STE I",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741336724",
            "telephone_number": "918-294-4803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHCREST MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "BREWER",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "DIRECTOR OF PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "877-892-9813"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southcrest Anesthesia Group LLC
• Southcrest Dialysis LLC (Southcrest Dialysis)
• Southcrest Emergency Physicians PC
• Southcrest LLC (SouthCrest Hospital)
• Southcrest LLC
• Southcrest Surgery Center LP (SouthCrest Surgicenter)
• Southern Hills Nursing Center Inc (Southern Hills Rehab Center)
• Southern Hills Rehab Center, LLC (Southern Hills Rehabilitation Center)
• Southern Hills Retirement Center, LLC (Southern Hills Assisted Living)
• Southern Pointe Dental and Implants LLC

• General Practice Physician in Tulsa, OK
• Providers in Tulsa, OK by specialty
• General Practice Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.