KYLE FANNING (NPI# 1184668998) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184668998 |
| Entity Type | Individual |
| Full Name | KYLE FANNING |
| Credential | MD |
| Practice Address |
1401 Sw 34th St Ste 200 Moore OK 73160-3059 |
| Mailing Address |
5300 N Independence Ave 280 Oklahoma City OK 73112-5556 |
| Practice Telephone | 4057931188 |
| Practice Fax Number | 4057930492 |
| Mailing Telephone | 4057931188 |
| Mailing Fax Number | 4057930492 |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2019-03-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 17631 | OK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100197770B | 05 | |
| OK | 100197770C | 05 |
| Street Address |
1401 SW 34TH ST STE 200 |
| City | MOORE |
| State | OK |
| Zip Code | 73160-3059 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912319534 | Kristy Miller | Nurse Practitioner | 1401 Sw 34th St Ste 200, Moore, OK 73160-3059 | 2014-06-02 |
| 1245590314 | Jessica Miki Foxen | Family Medicine | 1401 Sw 34th St Ste 200, Moore, OK 73160-3059 | 2012-05-23 |
| 1417243882 | Bob Joe Schank | Emergency Medicine | 1401 Sw 34th St Ste 200, Moore, OK 73160-3059 | 2011-06-23 |
| 1376779231 | Michael Mclaughlin | Pain Medicine | 1401 Sw 34th St Ste 200, Moore, OK 73160-3059 | 2009-06-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225678576 | Crystal Amanda Pitts | Student in an Organized Health Care Education/Training Program | 628 Allison Ln, Moore, OK 73160 | 2020-01-14 |
| 1982247623 | Tammie Lee Haworth | Occupational Therapy Assistant | Quest, 400 N Eastern Ave, Moore, OK 73160 | 2019-10-25 |
| 1477102580 | Php Management Group, LLC | Non-Pharmacy Dispensing Site | 1110 Magnolia Court, Moore, OK 73160 | 2019-09-11 |
| 1477117893 | Pharmology Moore LLC | Pharmacy | 1280 N Eastern Ave, Suite F, Moore, OK 73160 | 2019-05-01 |
| 1154891943 | Leah Cordell | Nurse Practitioner | 1280 North Eastern Ave., Suite F, Moore, OK 73160 | 2018-12-05 |
| 1467962332 | Healthcare Express, LLP | Clinic/Center | 551 Se 4th Street, Moore, OK 73160 | 2017-10-05 |
| 1306379557 | Dicarlo Venegas | Behavior Technician | 716 Wood Hollow Ln, Moore, OK 73160 | 2017-04-05 |
| 1073050167 | Tyron Dorrell Cosby Sr. | Case Manager/Care Coordinator | 1416 Penn Ln., Moore, OK 73160 | 2017-01-26 |
| 1326592650 | Kristin Kelley | Counselor | 1113 S Avery Dr, Moore, OK 73160 | 2016-08-03 |
| 1376912600 | Allison Kay Griffiths | Counselor | 9501 S. I-35 Service Rd, Apt 1504, Moore, OK 73160 | 2015-09-16 |
| Find all providers in zip 73160 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386997393 | Moore Clinic Inc | Family Medicine | 3162 N 3350 W, Moore, ID 83255 | 2012-10-16 |
| 1851676357 | Senthil Raju, Md Pllc | Family Medicine | 700 S. Telephone Road, Moore, OK 73160 | 2011-10-15 |
| 1063536233 | Moore Primary Care Inc | Family Medicine | 1400 Se 4th St, Ste H, Moore, OK 73160-7328 | 2007-03-16 |
| 1568504033 | Casey L Markland | Family Medicine | 700 S Telephone Rd # 201, Moore, OK 73160 | 2007-02-13 |
| 1548204902 | Misty Dawn Hsieh | Family Medicine | 1060 Sw 4th St, Moore, OK 73160-2494 | 2006-06-16 |
| 1336187285 | Dawna Mccreight | Family Medicine | 1227 N Santa Fe Ave, Moore, OK 73160-1850 | 2006-06-03 |
| 1407843212 | Keith R Layne | Family Medicine | 14800 S Western Ave, Moore, OK 73170-7112 | 2005-10-06 |
| 1922009075 | Senthil K Raju | Family Medicine | 700 S Telephone Rd, Moore, OK 73160-2502 | 2005-08-10 |
| 1902414592 | Molly Nicole Wright | Family Medicine | 551 Se 4th St, Moore, OK 73160-6790 | 2020-07-20 |
| 1871069724 | Teisha Alynn Gallegly | Family Medicine | 507 Ne 12th St, Moore, OK 73160-5807 | 2018-10-18 |
| Find all providers in MOORE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.