DR. LEROY SOUTHMAYD III (NPI# 1851351969) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851351969 |
| Entity Type | Individual |
| Full Name | DR. LEROY SOUTHMAYD III |
| Credential | M.D. |
| Practice Address |
1202 W Wilshire Blvd Oklahoma City OK 73116-6109 |
| Practice Telephone | 4058233073 |
| Mailing Telephone | 4058233073 |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2020-03-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
17164 | OK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100219420B | 05 |
| Street Address |
1202 W WILSHIRE BLVD |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73116-6109 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306455068 | Restore Family Counseling, LLC | Clinic/Center | 100 W. Wilshire, Suite #c3, Oklahoma City, OK 73116 | 2020-07-29 |
| 1861058877 | Dental Depot of 63rd & Nw Expressway, Pllc | Clinic/Center | 4025 Nw 63rd Street, Oklahoma City, OK 73116 | 2019-05-15 |
| 1073001756 | Oklahoma Clinical Management LLC | Prevention Professional | 4301 Nw 63rd St Ste 107, Oklahoma City, OK 73116 | 2018-04-27 |
| 1235658261 | Heinen Physical Therapy, PC | Clinic/Center | 7710 N May Ave, Oklahoma City, OK 73116 | 2017-09-11 |
| 1235657842 | Jacque S Komers | Counselor | 6501 N Broadway Ext Suite 180, Oklahoma City, OK 73116 | 2017-09-04 |
| 1164943874 | Jo Ann Cole-johnson | Counselor | 6505 N. Shawnee Ave, Oklahoma, OK 73116 | 2017-07-03 |
| 1548790793 | Zachary Wayne Skates | Case Manager/Care Coordinator | North 6501 Broadway Extention Highway #180, Oklahoma City, OK 73116 | 2017-06-19 |
| 1548622673 | Jessica Defiore | Case Manager/Care Coordinator | 6501 N Broadway Extension, Oklahoma City, OK 73116 | 2016-03-28 |
| 1093173247 | Patrice Ann Cook | Specialist/Technologist, Other | 7700 N. Hudson Ave, Suite Number 9, Oklahoma City, OK 73116 | 2016-02-03 |
| 1467880708 | Abrina Marie Kneeland | Occupational Therapy Assistant | 6525 N. Meridian #311, Therapists Unlimited Division of Career Staff, Oklahoma City, OK 73116 | 2013-10-24 |
| Find all providers in zip 73116 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710416573 | Universal Kidney Care of Oklahoma Pllc | Internal Medicine | 5300 N Independence Ave Ste 280, Oklahoma City, OK 73112-5555 | 2017-06-06 |
| 1710393160 | Narisorn Atsava-svate | Internal Medicine | 3400 Nw Expressway Ste 700, Oklahoma City, OK 73112-4492 | 2014-07-07 |
| 1730515362 | Fazal Akbar Ali Md PC | Internal Medicine | 4221 S Western Ave Ste 5020, Oklahoma City, OK 73109-3445 | 2013-09-14 |
| 1609030345 | Ahmad Bilal | Internal Medicine | 3366 Nw Expressway #730, Bldg D, Oklahoma City, OK 73112 | 2008-07-11 |
| 1134272933 | Rajesh Kumar | Internal Medicine | 810 Nw 10th St, Suite A, Oklahoma City, OK 73106-7215 | 2007-01-18 |
| 1265510101 | Radhika Medipalli | Internal Medicine | 13901 Mcauley Blvd Ste 303, Oklahoma City, OK 73134-8704 | 2006-11-01 |
| 1770684037 | Gigi J Toma | Internal Medicine | 810 Nw 10th Street, Suite A, Oklahoma City, OK 73106 | 2006-09-26 |
| 1033146550 | T V Venkataraman | Internal Medicine | 1110 N Classen Blvd Ste 200, Oklahoma City, OK 73106 | 2006-06-28 |
| 1326047226 | Chris M Sholer | Internal Medicine | 4334 Nw Expressway Ste 106, Oklahoma City, OK 73116-1515 | 2005-07-21 |
| 1689679623 | Sudhir Kumar Khanna | Internal Medicine | 3366 Nw Expressway, Ste 550, Oklahoma City, OK 73112-4489 | 2005-06-16 |
| Find all providers in OKLAHOMA CITY | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73116 |
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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.