Organization Active NPI

Douglas Menz, D.O. P.C.

Doing business as Lake Pointe Medical Center

  • Primary Care Clinic/Center
  • Harrah, OK
National Provider Identifier
1992996789
Registry record updated Aug 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
3408 Issued in OK
Legal business name
DOUGLAS MENZ, D.O. P.C.
Doing business as
Lake Pointe Medical Center
Practice address
20912 SE 29TH St
Harrah, OK 73045-6439
Phone
(405) 391-2970
Fax
(405) 391-2972
NPI assigned
Aug 6, 2007
Last updated
Aug 19, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2008

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

Authorized official

Name
Dr. George Douglas Menz, D.O.NPI 1518977628
Title
Physician/Owner
Phone
(405) 391-2970

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 3408 OK Primary

Addresses

Primary practice location

20912 SE 29TH St
Harrah, OK 73045-6439

Mailing address

20912 SE 29TH St
Harrah, OK 73045-6439
Phone (405) 391-2970

Other names 1

  • Lake Pointe Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100514000284 OK Part B Supplier - Clinic/Group Practice 5092843821 Receives reassigned benefits from 1 practitioner
Practice locations: Harrah, OK

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D0997934Lake Pointe Medical Center20912 SE 29TH Street, Harrah, OK 73045Certificate of waiverAug 2, 2027

National Provider Directory

National Provider Directory

Locations

20912 SE 29th St
Harrah, OK 73045
Phone (405) 391-2970

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219104000000",
    "number": "1992996789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20912 SE 29TH ST",
            "city": "HARRAH",
            "state": "OK",
            "postal_code": "730456439",
            "telephone_number": "405-391-2970",
            "fax_number": "405-391-2972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20912 SE 29TH ST",
            "city": "HARRAH",
            "state": "OK",
            "postal_code": "730456439",
            "telephone_number": "405-391-2970",
            "fax_number": "405-391-2972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS MENZ, D.O. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-06",
        "last_updated": "2008-08-19",
        "status": "A",
        "authorized_official_last_name": "MENZ",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "405-391-2970",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "OK",
            "license": "3408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Pointe Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Harrah, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2008; 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.

Verify at the official NPI Registry.