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Last Update: Monday, December 23, 2024 3:49 AM CST
Next Update: Monday, December 23, 2024 12:00 PM CST
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SELF, KRISTI GOODWIN
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This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.
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| Practice Address: |
4219 S WESTERN
OKLAHOMA CITY OK 73109
Address last updated on 6/4/2024 |
| Phone #: |
(405) 644-5356 |
| Fax #: |
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| County: |
OKLAHOMA |
| License: |
18173 |
| Dated: |
7/1/1992 |
| Expires: |
7/1/2025 |
| License Type: |
Medical Doctor |
| Specialty: |
Physical Medicine & Rehabilitation |
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| Status: |
Active |
| Status Class: |
Fully Licensed |
| Restricted to: |
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| Registered to Dispense: |
NO |
| Medical School: |
Univ Of Ok Coll Of Med, Oklahoma City Ok 73190 |
| Graduated: |
5 /
1988 |
| CME Year: |
2027 |
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Pending and/or Past Disciplinary Actions:
No Disciplinary Action Taken.
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All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
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| Certifications: |
AMERICAN BOARD OF PHYSICAL MEDICINE/REHABILITATION |
| New Patients: |
No |
| Medicaid: |
Yes |
| Medicare: |
Yes |
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| HMO/PPO: |
Aetna HMO
Aetna Managed Choice
Aetna PPO
Blue Cross Blue Shield-Blue Preferred
Blue Cross Blue Shield-Blue Traditional
Blue Cross Blue Shield-Plan 65 Select
BlueChoice PPO
CIGNA PPO
CommunityCare HMO, Inc
First Health
Global Health HMO
HealthChoice
PPO Oklahoma
Preferred Community Choice
Railroad Medicare
Secure Horizons HMO
SoonerCare HMO
Tricare for Life
Tricare Standard
United Healthcare Choice
United Healthcare Options PPO
United Healthcare POS |
| Hospital Privileges: |
INTEGRIS Baptist Medical Center
Oklahoma City, OK
INTEGRIS Edmond
Edmond, OK
INTEGRIS Southwest Medical Center
Oklahoma City, OK
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| Locations: |
Hours: |
Languages: |
4219 S WESTERN
OKLAHOMA CITY OK 73109
Phone #:
(405) 644-5356
Fax #:
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Mon: NO OUTPATIENT PRACTICE ANYMORE
Tue:
Wed:
Thu:
Fri:
Sat:
Sun: PRN JIM THORPE REHAB INPATIENT |
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