Active NPI
Daniel Scott Matlock, CRNA
- Certified Registered Nurse Anesthetist
- Norman, OK
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- R0064933
- Practice address
- 3650 W Rock Creek Rd
Suite 100
Norman, OK 73072-2202 - Phone
- (405) 701-3418
- Fax
- (405) 701-3451
- NPI assigned
- Mar 24, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | R0064933 | OK | Primary |
Addresses
Primary practice location
3650 W Rock Creek Rd
Suite 100
Norman, OK 73072-2202
Mailing address
3650 W Rock Creek Rd
Suite 100
Norman, OK 73072-2202
Phone (405) 701-3418
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200077660A | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1102 W Macarthur St
Shawnee, OK 74804-1743
Phone (405) 878-8110
Hospital & facility affiliations
- SSM Health St Anthony Hospital - Shawnee
Merit-based Incentive Payment System (MIPS)
- Final score
- 99.2 of 100
- Quality
- 93.03
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 93.93
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 95.2
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R0064933 | OK | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Anthony Shawnee Hospital Inc | Current | Accepting new patients | |
| St. Anthony Shawnee Hospital, Inc. | Current | Accepting new patients | |
| Nga Anesthesia PLLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
Locations
7106 Solutions Ctr
Chicago, IL 60677
1515 N Porter Ave
Norman, OK 73071
Phone (405) 366-8619
1102 W MacArthur St
Shawnee, OK 74804
Phone (405) 273-2270
Organizations & group practices 4
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.
-
- Surgery Physician
- Shawnee, OK
- NPI 1619260411
-
- Certified Registered Nurse Anesthetist
- Norman, OK
- NPI 1134408701
Nurse Anesthetist, Certified Registered
-
- Certified Registered Nurse Anesthetist
- Oklahoma City, OK
- NPI 1033283932
-
- Community/Retail Pharmacy
- Shawnee, OK
- NPI 1912739020
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Shawnee, OK
- NPI 1134123193
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1304035200000",
"number": "1992765838",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3650 W ROCK CREEK RD",
"address_2": "SUITE 100",
"city": "NORMAN",
"state": "OK",
"postal_code": "730722202",
"telephone_number": "405-701-3418",
"fax_number": "405-701-3451"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3650 W ROCK CREEK RD",
"address_2": "SUITE 100",
"city": "NORMAN",
"state": "OK",
"postal_code": "730722202",
"telephone_number": "405-701-3418",
"fax_number": "405-701-3451"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATLOCK",
"first_name": "DANIEL",
"middle_name": "SCOTT",
"credential": "CRNA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-03-24",
"last_updated": "2011-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "OK",
"license": "R0064933",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200077660A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}
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 Apr 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.