NPI Code Detail JSON Logo

1538963459 NPI number — ENID MEDICINE & ENDOSCOPY

NPI Number: 1538963459
Health Care Provider/Practitioner: ENID MEDICINE & ENDOSCOPY

Information about “1538963459” NPI (ENID MEDICINE & ENDOSCOPY) exists in 1538963459 in HTML format HTML  |  1538963459 in plain Text format TXT  |  1538963459 in PDF (Portable Document Format) PDF  |  1538963459 in an XML format XML  formats.

NPI Number : 1538963459 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1538963459",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "ENID MEDICINE & ENDOSCOPY",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 129",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ENID",
    "MailingAddressStateName": "OK",
    "MailingAddressPostalCode": "73702-0129",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "580-205-2009",
    "MailingAddressFaxNumber": "580-238-4259",
    "FirstLinePracticeLocationAddress": "330 E CHEROKEE AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ENID",
    "PracticeLocationAddressStateName": "OK",
    "PracticeLocationAddressPostalCode": "73701-5714",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "580-205-2009",
    "PracticeLocationAddressFaxNumber": "580-238-4259",
    "EnumerationDate": "04/01/2025",
    "LastUpdateDate": "10/17/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "SCHULTZ",
    "AuthorizedOfficialFirstName": "CRISTOPHER",
    "AuthorizedOfficialMiddleName": "D",
    "AuthorizedOfficialTitle": "PHYSICIAN",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "DO",
    "AuthorizedOfficialTelephoneNumber": "580-747-6359",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207R00000X",
          "TaxonomyName": "Internal Medicine Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207RG0100X",
          "TaxonomyName": "Gastroenterology Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        }
      ]
    }
  }
}
                
            

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