DEREK TODD LANDIS MD NPI 1487854642

NPI Information

  • NPI: 1487854642
  • Provider Name: DEREK TODD LANDIS, MD
  • Classification: Pediatrics - 208000000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 921 14TH AVE NW
    ARDMORE, OK
    ZIP 73401
  • Phone: (580) 223-5311

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NPI Details

Derek Todd Landis, MD is a pediatrics in Ardmore, OK with 22 years of experience. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. Derek Todd Landis, MD NPI is 1487854642. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF MIAMI, LM MILLER SCHOOL OF MEDICINE
Graduation Year:2004

The provider's business location address is:

921 14TH AVE NW
ARDMORE, OK
ZIP 73401-837
Phone: (580) 223-5311
Fax: (580) 223-8227

The NPI 1487854642 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/24/2007 and was last updated on 5/20/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208000000XPediatrics25666OKLAHOMAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
136032OTHEROKLAHOMAOBNDD LICENSE
225666OTHEROKLAHOMAOKLAHOMA MEDICAL LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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