Keith L Stanley, MD

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

15232 Issued in OK

Practice address

4802 S 109TH East Ave
Tulsa, OK 74146-5822

Phone

(918) 392-1400

Fax

(918) 392-1488

NPI assigned

Mar 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: keith.stanley@direct.stjohnhealthsystem.com
• Direct secure messaging: keith.stanley@tbja.gwaydirect.com

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.

• Osu Health System Anesthesia

  • Anesthesiology Physician
  • Columbus, OH
  • NPI 1174581185
  NPD (past)

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193875200000",
    "number": "1992773188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4802 S 109TH E AVENUE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74146",
            "telephone_number": "918-392-1400",
            "fax_number": "918-392-1488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4802 S 109TH EAST AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741465822",
            "telephone_number": "918-392-1400",
            "fax_number": "918-392-1488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANLEY",
        "first_name": "KEITH",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2007-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "OK",
            "license": "15232",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00155592",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stanley S Groom DDS and Associates PC
• Christa Marie Stanley
• Clinton Kenneth Stanley, BSN, RN
• Jeffrey Stanley
• Katina Danelle Stanley
• Kyle Stanley
• Philip Stanley
• Shaunda Stanley, RN
• Terra Jo Stansell, L.P.C.
• Kelli Stansifer

• Sports Medicine (Family Medicine) Physician in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Sports Medicine (Family Medicine) Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2007; 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.