SSM HEALTHCARE OF OKLAHOMA, INC (NPI# 1467967604) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467967604 |
| Entity Type | Organization |
| Organization Name | SSM HEALTHCARE OF OKLAHOMA, INC |
| Other Organization Name | ST ANTHONY CANCER SPECIALISTS OF OKLAHOMA @ EDMOND |
| Practice Address |
9 N Bryant Ave Edmond OK 73034-6307 |
| Practice Telephone | 4052854011 |
| Practice Fax Number | 4052850096 |
| Mailing Telephone | 4052854011 |
| Mailing Fax Number | 4052850096 |
| Enumeration Date | 2017-12-11 |
| Last Update Date | 2017-12-11 |
| Authorized Official Name | CRYSTAL L PENA (INSURANCE CREDENTIALING SPECIALIST) |
| Authorized Official Telephone | 4052727452 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
OK | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| St Anthony Cancer Specialists of Oklahoma @ Edmond | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659886893 | Ssm Healthcare of Oklahoma, Inc | Internal Medicine | 1614 Professional Cir, Yukon, OK 73099-6314 | 2017-12-11 |
| 1093125072 | Ssm Healthcare of Oklahoma, Inc | Internal Medicine | 608 Nw 9th St, Suite 3206, Oklahoma City, OK 73102-1068 | 2014-04-30 |
| 1033408497 | Ssm Healthcare of Oklahoma, Inc | Surgery | 608 Nw 9th St, Suite 5204, Oklahoma City, OK 73102-1068 | 2011-04-06 |
| 1942599303 | Ssm Healthcare of Oklahoma, Inc | Internal Medicine | 608 Nw 9th St, Suite 3110, Oklahoma City, OK 73102-1068 | 2011-04-06 |
| 1639478753 | Ssm Healthcare of Oklahoma, Inc | Internal Medicine | 608 Nw 9th St, Suite 4106, Oklahoma City, OK 73102-1068 | 2011-03-16 |
| 1710283189 | Ssm Healthcare of Oklahoma, Inc | Surgery | 535 Nw 9th St, Suite 205, Oklahoma City, OK 73102-1070 | 2011-02-02 |
| Street Address |
9 N BRYANT AVE |
| City | EDMOND |
| State | OK |
| Zip Code | 73034-6307 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215123153 | Fep LLC | Clinic/Center | 9 N Bryant Ave, Edmond, OK 73034-6307 | 2007-09-24 |
| 1336767383 | Southern Plains Medical Center Inc | Dermatology | 9 N Bryant Ave, Edmond, OK 73034-6307 | 2020-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306447172 | Saints Medical Group, LLC | Family Medicine | 2749 Progressive Dr, Suite B, Edmond, OK 73034 | 2020-11-06 |
| 1194339861 | Susan Haesook Kim | Pharmacist | 1400 2nd St, Edmod, Edmond, OK 73034 | 2020-09-01 |
| 1821616038 | Aaron Michael Gowens | Specialist/Technologist | 015 Wantland Hall 100 University Dr., Edmond, OK 73034 | 2020-07-14 |
| 1043834849 | Paddington Place Lcc | Intermediate Care Facility, Mental Illness | 3225 French Park Drive, Suite 6, Edmond, OK 73034 | 2020-06-08 |
| 1083254932 | Purpose Healthcare Inc | Psychologist | 301 South Blvd, Suite 117, Edmond, OK 73034 | 2020-01-08 |
| 1740773662 | Healthcare Express, LLP | Family Medicine | 2300 E 2nd St, Edmond, OK 73034 | 2018-06-14 |
| 1427555713 | Sara Nicole Smith | Specialist/Technologist | 100 N University Drive, Attn: Athletic Training Room, Edmond, OK 73034 | 2018-04-12 |
| 1619475084 | Carissa Leigh Brackelsberg | Chiropractor | 3709 E 2nd St, Edmond, OK 73034 | 2018-01-31 |
| 1760996177 | Laurel Michelle Glendening | Physical Therapist | 3531 River Wood Lane, Edmond, OK 73034 | 2017-11-21 |
| 1134643380 | Keith S Quinn | Dentist | 3008 Peaceful Ln, Edmond, OK 73034 | 2017-07-31 |
| Find all providers in zip 73034 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225229461 | Roseleen Sadruddin Charania | Internal Medicine | 1227 E 9th St, Edmond, OK 73034-5708 | 2007-08-05 |
| 1386936615 | Midwest Oncology Group Pllc | Internal Medicine | 1227 E 9th St, Edmond, OK 73034-5708 | 2011-05-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548725302 | Saint Medical Group, LLC | Internal Medicine | 3525 Nw 56th St Ste 150c, Oklahoma City, OK 73112-4516 | 2019-02-06 |
| 1659886893 | Ssm Healthcare of Oklahoma, Inc | Internal Medicine | 1614 Professional Cir, Yukon, OK 73099-6314 | 2017-12-11 |
| 1114430022 | Ssm Health Care of Oklahoma Inc | Internal Medicine | 3525 Nw 56th St Ste 100d, Oklahoma City, OK 73112-4549 | 2017-11-14 |
| 1821528662 | Cancer Centers of Southwest Oklahoma, LLC | Internal Medicine | 210 South Mary Bailey Drive, Chickasha, OK 73018 | 2017-06-14 |
| 1730403882 | Oklahoma Oncology and Hematology, P.C. | Internal Medicine | 1810 E 15th St, Tulsa, OK 74104-4611 | 2010-03-18 |
| 1851615918 | Oklahoma Oncology and Hematology, P.C. | Internal Medicine | 1220 W Willow Rd Ste A, Enid, OK 73703-2529 | 2010-03-18 |
| 1902137540 | Hassan Hatoum | Internal Medicine | 800 Ne 10th St. Okcc 2001-6, Stephenson Cancer Center//university of Oklahoma Health, Oklahoma City, OK 73104 | 2010-01-21 |
| 1235397654 | Agnel Rajani Raparthi | Internal Medicine | 800 Ne 10th St # 6071, Oklahoma City, OK 73104-5418 | 2008-06-02 |
| 1629282389 | Christopher Mark Manus | Internal Medicine | 3470 E Frank Phillips Blvd, Bartlesville, OK 74006-2406 | 2007-05-10 |
| 1760534127 | Carla Kurkjian | Internal Medicine | 4401 Mcauley Blvd, Suite 2700, Oklahoma City, OK 73120-8341 | 2007-01-17 |
| Find all providers with the same taxonomy | ||||
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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.